Provider Demographics
NPI:1861528465
Name:KALAMCHI, SABAH (DDS)
Entity type:Individual
Prefix:DR
First Name:SABAH
Middle Name:
Last Name:KALAMCHI
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 1:8112 N 87TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4335
Mailing Address - Country:US
Mailing Address - Phone:480-945-2310
Mailing Address - Fax:480-941-1362
Practice Address - Street 1:8112 N 87TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4335
Practice Address - Country:US
Practice Address - Phone:480-945-2310
Practice Address - Fax:480-941-1362
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4070204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4070Medicare UPIN