Kalyan Dandala, MD PLLC

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

MD00048010 Issued in WA

Legal business name

KALYAN DANDALA, MD PLLC

Doing business as

DanMed

Practice address

350 S 38TH CT Ste 100
Renton, WA 98055-5777

Phone

(714) 828-1800

Fax

(714) 882-1186

NPI assigned

Feb 8, 2013

Last updated

May 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Magdalen Gustilo

Title

Director of Payer Relations

Phone

(714) 568-7667

Specialties & licenses 2

Addresses

Other names 1

• DanMed Doing business as

Electronic endpoints 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jane Bell

  • Nurse Practitioner
  • Puyallup, WA
  • NPI 1811651474
  NPD
• Thai Ly, ARNP

  • Nurse Practitioner
  • Tacoma, WA
  • NPI 1346902509
  NPD
• Sambridhi Shrestha, DNP

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1073495479
  NPD

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1558600650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 VON KARMAN AVE STE 500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128531",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 38TH CT STE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555777",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2302 S Union Ave Ste 30",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984051361",
            "country_code": "US",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1370 116th Ave NE Ste 210",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043825",
            "country_code": "US",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Westlake Ave N Ste 508",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981093528",
            "country_code": "US",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KALYAN DANDALA, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "WA",
            "license": "MD00048010",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30007637",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dandalak@danmedtms.com",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "350 S 38th Ct Ste 100",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "DanMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaiser Foundation Health Plan of Washington (Kaiser Permanente WA Mail Order Pharmacy)
• Kaiser Foundation Health Plan of Washington
• Kaiser Foundation Health Plan of Washington
• Kaiser Foundation Health Plan of Washington
• Aditi Kakade, OD
• Lucy Kamau
• Sharyl K.N. Kamihara, PT
• Michael J. Kaminski, MD
• Ekaterina A Kanevski, RPH
• Haereen Kang, RN

• Addiction Psychiatry Physician in Renton, WA
• Providers in Renton, 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 May 8, 2023; 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.