Provider Demographics
NPI:1194348136
Name:TAMMAREDDY, SNEHA (DDS)
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:TAMMAREDDY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 LIBERTY LOOP
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-5411
Mailing Address - Country:US
Mailing Address - Phone:908-745-8797
Mailing Address - Fax:
Practice Address - Street 1:1705 AMHERST ST STE 102
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3346
Practice Address - Country:US
Practice Address - Phone:540-667-8731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014178181223G0001X, 122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program