Kishore Vel Damodaran, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14618 Issued in MN

Practice address

615 16TH St SW
Rochester, MN 55902-2103

Phone

(507) 288-2539

NPI assigned

Jun 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• RPM Group

  • Dentist
  • Rochester, MN
  • NPI 1841846854
  NPD

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1700456142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BOARD CIR",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151981",
            "telephone_number": "651-249-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 16TH ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559022103",
            "telephone_number": "507-288-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMODARAN",
        "first_name": "KISHORE",
        "middle_name": "VEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14618",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard C Daly, M.D.
• Kent CJ Dalzell, PAC
• Nehaa Dambala, MD
• Moussab Damlaj, MD
• Julie Ellen Dammann, M.A., L.P.
• Rachel Garbo Damroth
• Malik Errol Dancy, MD
• Daniel Danczyk, M.D.
• Dande Products and Services LLC
• Shilpa Dandekar, FNP

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.