Gaddam, Vijay Bhaskar Reddy

Gaddam, Vijay Bhaskar Reddy is an sole proprietor health care provider with primary practice located at 1073 Riverdale St , West Springfield MA 01089-4614. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gaddam, Vijay Bhaskar Reddy can be contacted via phone (413) 285-7114.

Contact Information

Primary practice address
1073 Riverdale St West Springfield MA 01089-4614
Phone: (413) 285-7114
Fax: (413) 285-7168
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 25779 Texas
Dental Providers / General Practice 1223G0001X 22226 Massachusetts

Profile Details

NPI number 1821250820
LBN Legal business name Gaddam, Vijay Bhaskar Reddy
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2008
Last updated Jul 7th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821250820 NPPES
Massachusetts MEDICAID 9211482

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