Provider Demographics
NPI:1679919849
Name:KAMATH, RAMYA SHYAMALA (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMYA
Middle Name:SHYAMALA
Last Name:KAMATH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RAMYA
Other - Middle Name:SHYAMALA
Other - Last Name:KANUKOLLU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6618 SITIO DEL RIO BLVD STE B102
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-1146
Mailing Address - Country:US
Mailing Address - Phone:512-900-5437
Mailing Address - Fax:
Practice Address - Street 1:6618 SITIO DEL RIO BLVD STE B102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-1146
Practice Address - Country:US
Practice Address - Phone:512-900-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD110361223P0221X
IL021.0028351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry