Provider Demographics
NPI:1821408535
Name:KAMEL, ANDREA (DMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KAMEL
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 1:4650 N CENTRAL AVE
Mailing Address - Street 2:APT 366
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4650 N CENTRAL AVE
Practice Address - Street 2:APT 366
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1068
Practice Address - Country:US
Practice Address - Phone:602-810-6334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist