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General NPI Number Information
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NPI Number | 1114602703
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Entity Type | Individual
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Provider Name | KRZYSZTOF KAMOCKI MD, DDS, PHD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 5945 CRAWFORDSVILLE RD
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City | SPEEDWAY
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State | IN
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Zip | 46224-3728
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Country | US
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Telephone | 317-243-2152
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Fax |
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Provider Business Mailing Address
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Address Line | 2934 SUNMEADOW CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46228-3196
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Country | US
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Telephone | 317-902-4488
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12014256A
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License Number State | IN
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