Provider Demographics
NPI:1881940443
Name:KALAVADIYA, AMIT (DMD)
Entity type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:KALAVADIYA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S 5TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1680
Mailing Address - Country:US
Mailing Address - Phone:215-538-0665
Mailing Address - Fax:215-538-0666
Practice Address - Street 1:127 S 5TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1680
Practice Address - Country:US
Practice Address - Phone:215-538-0665
Practice Address - Fax:215-538-0666
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0389921223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice