Healthcare Provider Details

I. General information

NPI: 1750299186
Provider Name (Legal Business Name): DIYA JAYANTH KAMDAR BDS, CERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5402 FARM TO MARKET 2920, SUITE 5
SPRING TX
77388
US

IV. Provider business mailing address

3400 MONTROSE BLVD APT 1916
HOUSTON TX
77006-4362
US

V. Phone/Fax

Practice location:
  • Phone: 832-447-1023
  • Fax:
Mailing address:
  • Phone: 585-981-7321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42916
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number42916
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number42916
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: