Provider Demographics
NPI:1194965293
Name:SUNKIREDDY BAKKIREDDY, KALPANA (DDS)
Entity type:Individual
Prefix:DR
First Name:KALPANA
Middle Name:
Last Name:SUNKIREDDY BAKKIREDDY
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 1:4505 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8505
Mailing Address - Country:US
Mailing Address - Phone:732-267-8090
Mailing Address - Fax:
Practice Address - Street 1:4505 SPICEWOOD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8505
Practice Address - Country:US
Practice Address - Phone:732-267-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31732122300000X, 1223G0001X
PADS0377361223G0001X
NJ22D1024012001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist