Individual
DIVYA REDDY PEDDIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
3070 BRISTOL ST STE 180, COSTA MESA, CA 92626-3072
(714) 924-4824
Mailing address
184 STONECLIFFE AISLE, IRVINE, CA 92603-5715
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DDS62530
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DDS62530
CA
Other
Enumeration date
07/10/2013
Last updated
02/14/2024
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