Provider Demographics
NPI:1902242688
Name:KAPOOR, AMIT (DDS)
Entity type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:KAPOOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119-1328
Mailing Address - Country:US
Mailing Address - Phone:413-372-5565
Mailing Address - Fax:
Practice Address - Street 1:1245 BOSTON RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01119-1328
Practice Address - Country:US
Practice Address - Phone:413-372-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856282122300000X
TX30705122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist