Provider Demographics
NPI:1982132791
Name:NALLAPAREDDY, DEEPA (DDS)
Entity type:Individual
Prefix:
First Name:DEEPA
Middle Name:
Last Name:NALLAPAREDDY
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 1:2042 COLUSA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-1807
Mailing Address - Country:US
Mailing Address - Phone:408-510-4538
Mailing Address - Fax:
Practice Address - Street 1:2042 COLUSA WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95130-1807
Practice Address - Country:US
Practice Address - Phone:408-510-4538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1013691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice