Provider Demographics
NPI:1417828732
Name:EKDANTA DENTAL GROUP LLC
Entity type:Organization
Organization Name:EKDANTA DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SAGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKADIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-744-3463
Mailing Address - Street 1:4579 S COBB DR SE STE 500
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6394
Mailing Address - Country:US
Mailing Address - Phone:770-438-1520
Mailing Address - Fax:
Practice Address - Street 1:4579 S COBB DR SE STE 500
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6394
Practice Address - Country:US
Practice Address - Phone:770-438-1520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty