Provider Demographics
NPI:1669150595
Name:KAMDAR, RICHA JAYESH (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHA
Middle Name:JAYESH
Last Name:KAMDAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 176TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5087
Mailing Address - Country:US
Mailing Address - Phone:206-605-4654
Mailing Address - Fax:
Practice Address - Street 1:23818 225TH AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5088
Practice Address - Country:US
Practice Address - Phone:425-358-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61451629122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist