Ambujakshan Dildeep, M.D

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35122500 Issued in OH

Practice address

3737 Southern Blvd
Suite 2000
Kettering, OH 45429-1262

Phone

(937) 610-1915

Fax

(937) 610-1917

NPI assigned

May 2, 2009

Last updated

Sep 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1241222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1184858334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL",
            "address_2": "SUITE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423794",
            "telephone_number": "937-752-2305",
            "fax_number": "937-522-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD",
            "address_2": "SUITE 2000",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291262",
            "telephone_number": "937-610-1915",
            "fax_number": "937-610-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILDEEP",
        "first_name": "AMBUJAKSHAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-02",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35122500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094140",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Marie Dickens, LSW
• Rosetta L Dickey, CPRS
• Elizabeth M Diem, PA
• Leslie Dierckman
• Verity C Digel, PAC
• Jennifer Dimarino, CRNA
• Adriana Joyce Dinatti, DO
• Sara Dingeman
• Thomas R Dixon, MD
• Scott A Doak, MD

• Surgery Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.