Active NPI
Aya Kamoona
- Pediatric Dentistry
- Princess Anne, MD
National Provider Identifier
1972253177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 18147
- Practice address
- 12165 Elm St
Princess Anne, MD 21853-1358 - Phone
- (410) 651-5151
- Fax
- (410) 651-4256
- NPI assigned
- Mar 28, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 18147 | MD | |
| Pediatric Dentistry | 1223P0221X | 18147 | MD | Primary |
Addresses
Primary practice location
12165 Elm St
Princess Anne, MD 21853-1358
Mailing address
PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015
Other practice location 1
637 Washington St
Boston, MA 02124-3510
Phone (508) 733-3522
Other practice location 2
45 Stuart St Apt 1613
Boston, MA 02116-4758
Phone (508) 733-3522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119591300 | Medicaid | MD |
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 |
|---|---|---|---|
| 18147 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750550400000",
"number": "1972253177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1978",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218021978",
"telephone_number": "410-749-1015",
"fax_number": "410-749-0654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12165 ELM ST",
"city": "PRINCESS ANNE",
"state": "MD",
"postal_code": "218531358",
"telephone_number": "410-651-5151",
"fax_number": "410-651-4256"
}
],
"practiceLocations": [
{
"address_1": "637 Washington St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021243510",
"country_code": "US",
"telephone_number": "508-733-3522",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "45 Stuart St Apt 1613",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021164758",
"country_code": "US",
"telephone_number": "508-733-3522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAMOONA",
"first_name": "AYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-28",
"last_updated": "2025-06-22",
"certification_date": "2025-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "18147",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MD",
"license": "18147",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119591300",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Princess Anne, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.