Provider Demographics
NPI:1407552433
Name:KARMM DENTAL GROUP PLLC
Entity Type:Organization
Organization Name:KARMM DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANKUR
Authorized Official - Middle Name:JAYENDRA
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:737-216-7732
Mailing Address - Street 1:2521 GREY MOUNTAIN PASS
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3986
Mailing Address - Country:US
Mailing Address - Phone:914-299-5219
Mailing Address - Fax:
Practice Address - Street 1:201 SAINT JOSEPH CT STE 101-102
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642-3403
Practice Address - Country:US
Practice Address - Phone:737-216-7731
Practice Address - Fax:737-216-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1164551867Medicaid
TX1528197225Medicaid
TX1497905400Medicaid