Dileep R Kondur, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN015814 Issued in GA

Practice address

231 Davis Rd
Augusta, GA 30907-2407

Phone

(706) 863-4212

Fax

(706) 863-0087

NPI assigned

Apr 2, 2018

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

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1477059145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 DAVIS RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072407",
            "telephone_number": "706-863-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 DAVIS RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072407",
            "telephone_number": "706-863-4212",
            "fax_number": "706-863-0087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1395 Center Dr Rm D10-6",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103631",
            "country_code": "US",
            "telephone_number": "706-513-7708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONDUR",
        "first_name": "DILEEP",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DRPM2050",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "DN015814",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "GA",
            "license": "DN015814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna R Koenigs
• Antoine Aka Koffi
• Robert Wynn Kogel, MD
• Ravindra Kolhe, M.D.PH.D
• Linda A Kolmar, PAC
• Feng-Ming Phoenix Kong, MD
• Travis C Konzelman, AGNP
• Amanda Korby, MA, LPC, CFRS
• Donald Jeffrey Korkis, M.D.
• Rawan Korman, MD

• Periodontics in Augusta, GA
• Providers in Augusta, GA by specialty
• Periodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.