Komal Kamath, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.026667 Issued in OH

Practice address

600 W 3Rd St
Mansfield, OH 44906-2633

Phone

(419) 522-2619

Fax

(419) 525-6723

NPI assigned

Aug 28, 2021

Sex

Female

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

Enrolled in OH

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

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.

• Third Street Community Clinic, Inc

  • Primary Care Clinic/Center
  • Mansfield, OH
  • NPI 1558576116
  NPD (past)
• Third Street Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ashland, OH
  • NPI 1710517339
  NPD (past)

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

{
    "created_epoch": "1630108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1912674748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 3RD ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062633",
            "telephone_number": "419-522-2619",
            "fax_number": "419-525-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 3RD ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062633",
            "telephone_number": "419-522-2619",
            "fax_number": "419-525-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMATH",
        "first_name": "KOMAL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-28",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Rogers Justice
• Anna Marie Kalashnik, OTR/L
• Mohan Rao Kamadana, M.D.
• Swapna Kamadana, M.D.
• Pamela Louise Kaman, CRNA
• John Charles Kamenik, PHARMD
• Ryan C Kamp, M.D.
• Stephanie L Kamp
• Aloys Kamwithi, LPC
• Kandhasamy Kannapiran, M.D;

• Dentist in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Dentist in Ohio

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

Verify at the official NPI Registry.