Kalyan Dandala, MD

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

MD00048010 Issued in WA

Practice address

1215 120TH Ave NE
Suite 201
Bellevue, WA 98005-2135

Phone

(425) 283-4200

Fax

(425) 458-7528

NPI assigned

Jan 26, 2007

Last updated

Jul 16, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1336295864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 VIRGINIA ST",
            "address_2": "UNIT 3107",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981014421",
            "telephone_number": "206-708-6877",
            "fax_number": "206-708-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 120TH AVE NE",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052135",
            "telephone_number": "425-283-4200",
            "fax_number": "425-458-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDALA",
        "first_name": "KALYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WA",
            "license": "MD00048010",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "WA",
            "license": "MD00048010",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00048010",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "WA",
            "license": "MD00048010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Damas
• Mark Damberg, PA-C
• Nazanin Dameshghi
• Erin Damitio, RBT
• Brook Richmire Damour, RC
• Sumedha Dandapanthula
• Fariba Daneshgaran, OD
• Caitlin Dang, LMHCA
• Kieu N Dang, PAC
• Minh Thu Dang, D.D.S.

• Addiction Psychiatry Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Addiction Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.