Individual provider Active NPI

Krzysztof Kamocki, MD, DDS, PHD

  • Dentist
  • Speedway, IN
National Provider Identifier
1114602703
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12014256A Issued in IN
Practice address
5945 Crawfordsville Rd
Speedway, IN 46224-3728
Phone
(317) 243-2152
NPI assigned
Jun 20, 2023
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12014256A IN Primary

Addresses

Primary practice location

5945 Crawfordsville Rd
Speedway, IN 46224-3728

Mailing address

2934 Sunmeadow CT
Indianapolis, IN 46228-3196
Phone (317) 902-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
12014256AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Experts, LLC General Practice PastSince Jun 1, 2023 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1114602703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2934 SUNMEADOW CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462283196",
            "telephone_number": "317-902-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5945 CRAWFORDSVILLE RD",
            "city": "SPEEDWAY",
            "state": "IN",
            "postal_code": "462243728",
            "telephone_number": "317-243-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMOCKI",
        "first_name": "KRZYSZTOF",
        "name_prefix": "Dr.",
        "credential": "MD, DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014256A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Speedway, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.