Active NPI
Kiran Kamdar, BDS, MSD, PC
- Pediatric Dentistry
- Stone Mountain, GA
National Provider Identifier
1346469699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN010597
- Practice address
- 5460 Lilburn Stone Mountain Rd
Stone Mountain, GA 30087-2843 - Phone
- (770) 923-2232
- Fax
- (770) 923-2268
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN010597 | GA | Primary |
Addresses
Primary practice location
5460 Lilburn Stone Mountain Rd
Stone Mountain, GA 30087-2843
Mailing address
5460 Lilburn Stone Mountain Rd
Stone Mountain, GA 30087-2843
Phone (770) 923-2232
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00412079A | Medicaid | GA | |
| 827601 | Other | GA | UNITED CONCORDIA NUMBER |
| DN010597 | Other | GA | GEORGIA LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN010597 | GA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kiran M. Kamdar Dba Neighborhood Pediatric and Adult Dentistry | Pediatric Dentistry | Past | 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.
-
- Pediatric Dentistry
- Stone Mountain, GA
- NPI 1881865434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726704000000",
"number": "1346469699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5460 LILBURN STONE MOUNTAIN RD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300872843",
"telephone_number": "770-923-2232",
"fax_number": "770-923-2268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5460 LILBURN STONE MOUNTAIN RD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300872843",
"telephone_number": "770-923-2232",
"fax_number": "770-923-2268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMDAR",
"first_name": "KIRAN",
"name_prefix": "Dr.",
"credential": "BDS, MSD, PC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2024-09-19",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "GA",
"license": "DN010597",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00412079A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA NUMBER",
"identifier": "827601",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA LICENSE NUMBER",
"identifier": "DN010597",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.