Healthcare Provider Details

I. General information

NPI: 1841769239
Provider Name (Legal Business Name): SANGHA KAMAT DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 ASHBY AVE STE 101
BERKELEY CA
94705-2439
US

IV. Provider business mailing address

3030 ASHBY AVE STE 101
BERKELEY CA
94705-2439
US

V. Phone/Fax

Practice location:
  • Phone: 510-841-3040
  • Fax: 510-841-3044
Mailing address:
  • Phone: 510-841-3040
  • Fax: 510-841-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: PRAJAKTA KAMAT
Title or Position: OWNER
Credential: DDS
Phone: 510-841-3040