MEDICARE: KARMA DENTAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1689401978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KARMA DENTAL LLC

Provider Business Mailing Address
First Line	:	4511 CHAMBLEE DUNWOODY RD STE A2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-6243
Country	:	US
Telephone Number	:	404-806-9799
Fax Number	:

Provider Business Practice Location Address
First Line	:	4511 CHAMBLEE DUNWOODY RD STE A2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-6243
Country	:	US
Telephone Number	:	404-806-9799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KETAN GINOYA
Credential	:	DMD
Telephone Number	:	617-510-7053

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	09/19/2024

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