Provider Demographics
NPI:1154635373
Name:KAMATH, CHAYA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAYA
Middle Name:R
Last Name:KAMATH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3680 BEACON AVENUE
Mailing Address - Street 2:SUITE 224
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538
Mailing Address - Country:US
Mailing Address - Phone:443-690-9878
Mailing Address - Fax:
Practice Address - Street 1:2390 SENTER RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-2616
Practice Address - Country:US
Practice Address - Phone:408-306-7420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA624741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics