Amanda Brown Kotis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9194 Issued in NC

Practice address

1207 Davie Ave
Statesville, NC 28677-3511

Phone

(704) 873-4271

NPI assigned

Jul 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

State licenses

Practice roles

Locations

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.

• Amanda B Kotis, DMD, PA

  • General Practice Dentistry
  • Statesville, NC
  • NPI 1518577667
  NPD Authorized official
• Londry & Modlin X DDS PLLC

  • General Practice Dentistry
  • Statesville, NC
  • NPI 1902535396
  NPD (past)

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1609007475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773511",
            "telephone_number": "704-873-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 DAVIE AVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773511",
            "telephone_number": "704-873-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTIS",
        "first_name": "AMANDA",
        "middle_name": "BROWN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9194",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "150746",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reanita Knight
• Lundyn Knisely
• Rachel Adrienne Knox, MA, CCC
• Deborah Kolarik, RN
• Angel Kolle
• Vihoale Abla Kpadenou, MD
• Gregory J Kuchtjak, DMD PA
• Katherine Barnard Kudlacek, M.A., CCC-SLP
• Jeffrey Reme Kuhlman, M.D.
• Adina Kulcsar, PA-C

• General Practice Dentistry in Statesville, NC
• Providers in Statesville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.