Individual provider Active NPI

Sahana Kodimoole, DMD

  • Dentist
  • Zephyrhills, FL
National Provider Identifier
1619866613
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30364 Issued in FL
Practice address
38180 Medical Center Ave
Zephyrhills, FL 33540-1380
Phone
(813) 780-1234
NPI assigned
Jul 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30364 FL Primary

Addresses

Primary practice location

38180 Medical Center Ave
Zephyrhills, FL 33540-1380

Mailing address

11051 Sundrift Dr
Tampa, FL 33647-3846
Phone (425) 614-5971

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

LicenseStateTypeSpecialty
30364FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1619866613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11051 SUNDRIFT DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473846",
            "telephone_number": "425-614-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38180 MEDICAL CENTER AVE",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335401380",
            "telephone_number": "813-780-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODIMOOLE",
        "first_name": "SAHANA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "30364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.