Active NPI
Ramakrishna Raju Kammili, DMD
- Dentist
- Fort Worth, TX
National Provider Identifier
1801025945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0025165
- Practice address
- 3825 Yucca Ave
Suite 101
Fort Worth, TX 76111-6022 - Phone
- (817) 831-9300
- NPI assigned
- Jul 10, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN1855212 | MA | |
| Dentist | 122300000X | 0025165 | TX | Primary |
Addresses
Primary practice location
3825 Yucca Ave
Suite 101
Fort Worth, TX 76111-6022
Mailing address
3825 Yucca Ave
Suite 101
Fort Worth, TX 76111-6022
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0025165 | TX | MD | Dentist |
| DN1855212 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1801025945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3825 YUCCA AVE",
"address_2": "SUITE 101",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761116022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3825 YUCCA AVE",
"address_2": "SUITE 101",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761116022",
"telephone_number": "817-831-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMMILI",
"first_name": "RAMAKRISHNA",
"middle_name": "RAJU",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-10",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN1855212",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "0025165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.