Active NPI
Ramya Shyamala Kamath, D.D.S.
- Pediatric Dentistry
- Austin, TX
National Provider Identifier
1679919849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D11036
- Practice address
- 6618 Sitio del Rio Blvd Ste B102
Austin, TX 78730-1146 - Phone
- (512) 900-5437
- NPI assigned
- May 15, 2013
- Sex
- Female
- Sole proprietor
- No
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 | D11036 | OR | Primary |
Addresses
Primary practice location
6618 Sitio del Rio Blvd Ste B102
Austin, TX 78730-1146
Mailing address
6618 Sitio del Rio Blvd Ste B102
Austin, TX 78730-1146
Phone (512) 900-5437
Other names 1
- Dr. Ramya Shyamala Kanukollu
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150930002582 | MO | Order and Referring Only - Dentist | 6103134762 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11036 | OR | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Austin Pediatric Dentistry PLLC | 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.
-
- Dental Clinic/Center
- Austin, TX
- NPI 1518383769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1679919849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6618 SITIO DEL RIO BLVD STE B102",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787301146",
"telephone_number": "512-900-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6618 SITIO DEL RIO BLVD STE B102",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787301146",
"telephone_number": "512-900-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMATH",
"first_name": "RAMYA",
"middle_name": "SHYAMALA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-15",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "D11036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RAMYA",
"last_name": "KANUKOLLU",
"middle_name": "SHYAMALA",
"prefix": "DR.",
"credential": "D.D.S.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.