Provider Demographics
NPI:1578629648
Name:KADEMANI, RUPAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:RUPAM
Middle Name:
Last Name:KADEMANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 FOXWOODS CT SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-6673
Mailing Address - Country:US
Mailing Address - Phone:507-535-0505
Mailing Address - Fax:
Practice Address - Street 1:379 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ZUMBROTA
Practice Address - State:MN
Practice Address - Zip Code:55992-1543
Practice Address - Country:US
Practice Address - Phone:507-732-5346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice