Provider Demographics
NPI:1558847533
Name:IRA KAMP DDS
Entity Type:Organization
Organization Name:IRA KAMP DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:KAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:607-272-4331
Mailing Address - Street 1:1025 N TIOGA ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-3629
Mailing Address - Country:US
Mailing Address - Phone:607-272-4331
Mailing Address - Fax:607-240-5618
Practice Address - Street 1:1025 N TIOGA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-3629
Practice Address - Country:US
Practice Address - Phone:607-272-4331
Practice Address - Fax:607-240-5618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAK1249792332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies