Provider Demographics
NPI:1619203247
Name:KAMDAR, NAVREET RAJU (DMD)
Entity Type:Individual
Prefix:
First Name:NAVREET
Middle Name:RAJU
Last Name:KAMDAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:NAVREET
Other - Middle Name:KAUR
Other - Last Name:RAJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3605 ALAMO ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2186
Mailing Address - Country:US
Mailing Address - Phone:805-526-3331
Mailing Address - Fax:
Practice Address - Street 1:3605 ALAMO ST
Practice Address - Street 2:SUITE 310
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2186
Practice Address - Country:US
Practice Address - Phone:805-526-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62408122300000X
MD144631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes122300000XDental ProvidersDentist