Provider Demographics
NPI:1326659640
Name:KADAM, SWAPNIL RANGNATH (DDS)
Entity Type:Individual
Prefix:
First Name:SWAPNIL
Middle Name:RANGNATH
Last Name:KADAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W COMMERCE ST APT 414
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1993
Mailing Address - Country:US
Mailing Address - Phone:805-216-3675
Mailing Address - Fax:
Practice Address - Street 1:3050 S 1ST ST STE 233
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3451
Practice Address - Country:US
Practice Address - Phone:972-840-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX365221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice