Healthcare Provider Details

I. General information

NPI: 1912839150
Provider Name (Legal Business Name): ZEALKUMARI KISANSINH INAMDAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8488 CHARLOTTE HWY STE 101
INDIAN LAND SC
29707-8158
US

IV. Provider business mailing address

623 CITRIADORA ST
FORT MILL SC
29715-8219
US

V. Phone/Fax

Practice location:
  • Phone: 839-400-2195
  • Fax:
Mailing address:
  • Phone: 857-274-1960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDGD.11442
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: