Individual provider Active NPI

James Kamada

  • Dentist
  • Chula Vista, CA
National Provider Identifier
1336727031
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107898 Issued in CA
Practice address
1690 Millenia Ave Ste 102
Chula Vista, CA 91915-2889
Phone
(619) 348-5324
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 107898 CA Primary

Addresses

Primary practice location

1690 Millenia Ave Ste 102
Chula Vista, CA 91915-2889

Mailing address

183 Willow Glenn Cir
Reedley, CA 93654-2740
Phone (559) 643-6306

Other practice location 1

71949 Highway 111 Ste 100B
Rancho Mirage, CA 92270-4826
Phone (559) 643-6306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20230120000808 CA Order and Referring Only - DentistPractitioner - Dentist 1254702772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carpio Dental Corporation Dentist PastSince Aug 28, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1336727031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 WILLOW GLENN CIR",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936542740",
            "telephone_number": "559-643-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 MILLENIA AVE STE 102",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919152889",
            "telephone_number": "619-348-5324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71949 Highway 111 Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922704826",
            "country_code": "US",
            "telephone_number": "559-643-6306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMADA",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.