NPI Code Detail JSON Logo

1205963980 NPI number — PETER PIMON KAMBHU DDS, MS

NPI Number: 1205963980
Health Care Provider/Practitioner: PETER PIMON KAMBHU DDS, MS

Information about “1205963980” NPI (PETER PIMON KAMBHU DDS, MS) exists in 1205963980 in HTML format HTML  |  1205963980 in plain Text format TXT  |  1205963980 in PDF (Portable Document Format) PDF  |  1205963980 in an XML format XML  formats.

NPI Number : 1205963980 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205963980",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KAMBHU",
    "FirstName": "PETER",
    "MiddleName": "PIMON",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DDS, MS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "180 HOLIDAY RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CORALVILLE",
    "MailingAddressStateName": "IA",
    "MailingAddressPostalCode": "52241-1175",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "319-337-7017",
    "MailingAddressFaxNumber": "319-337-2679",
    "FirstLinePracticeLocationAddress": "180 HOLIDAY RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CORALVILLE",
    "PracticeLocationAddressStateName": "IA",
    "PracticeLocationAddressPostalCode": "52241-1175",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "319-337-7017",
    "PracticeLocationAddressFaxNumber": "319-337-2679",
    "EnumerationDate": "02/28/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223P0700X",
        "TaxonomyName": "Prosthodontics",
        "LicenseNumber": "07392",
        "LicenseNumberStateCode": "IA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.