MEDICARE: NAVREET RAJU KAMDAR D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	62408	CA

General Provider Information

NPI Number	:	1619203247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAVREET RAJU KAMDAR D.M.D.

Provider Business Mailing Address
First Line	:	3605 ALAMO ST
Second Line	:	SUITE 310
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2186
Country	:	US
Telephone Number	:	805-526-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	3605 ALAMO ST
Second Line	:	SUITE 310
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2186
Country	:	US
Telephone Number	:	805-526-3331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2009
Last Update Date	:	03/25/2014

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