MEDICARE: BITA K KAMALI D.D.S

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	20099	TX

General Provider Information

NPI Number	:	1801929120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BITA K KAMALI D.D.S

Provider Business Mailing Address
First Line	:	5072 W PLANO PKWY
Second Line	:	SUITE 250
City	:	PLANO
State	:	TX
Zip	:	75093-4476
Country	:	US
Telephone Number	:	972-818-1300
Fax Number	:	972-818-1301

Provider Business Practice Location Address
First Line	:	5072 W PLANO PKWY
Second Line	:	SUITE 250
City	:	PLANO
State	:	TX
Zip	:	75093-4476
Country	:	US
Telephone Number	:	972-818-1300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	02/16/2017

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