Mamta M. Kori, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21541 Issued in OH

Practice address

3420 Atrium Blvd Ste 100
Franklin, OH 45005-5186

Phone

(855) 912-7677

Fax

(513) 424-2147

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• K&E Advanced Dentistry GPS LLC

  • Dental Clinic/Center
  • Middletown, OH
  • NPI 1457075418
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1083780159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 ATRIUM BLVD STE 100",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450055186",
            "telephone_number": "855-912-7677",
            "fax_number": "513-424-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 ATRIUM BLVD STE 100",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450055186",
            "telephone_number": "855-912-7677",
            "fax_number": "513-424-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORI",
        "first_name": "MAMTA",
        "middle_name": "M.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "21541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2371866",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nichole Kingsley, RN
• Paul J Kleemann, O.D.
• Ronald S Klein, MD
• Joan M Kolodzik, MD
• Cynthia A Kordelski, MD
• Alyse Korpela, MS, CCC-SLP
• Heather J Koster, APRN, CPNP-PC
• Anthony D Krebs, M.D.
• Kevin R. Kroeger, M.D.
• Daniel Kroger, RN

• General Practice Dentistry in Franklin, OH
• Providers in Franklin, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.