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General NPI Number Information
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NPI Number | 1346469699
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Entity Type | Individual
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Provider Name | KIRAN KAMDAR BDS, MSD, PC
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 5460 LILBURN STONE MOUNTAIN RD
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-2843
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Country | US
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Telephone | 770-923-2232
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Fax | 770-923-2268
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Provider Business Mailing Address
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Address Line | 5460 LILBURN STONE MOUNTAIN RD
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-2843
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Country | US
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Telephone | 770-923-2232
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Fax | 770-923-2268
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN010597
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License Number State | GA
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