Healthcare Provider Details

I. General information

NPI: 1811732084
Provider Name (Legal Business Name): NIKHAR PARITOSH MANKAD D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date: 03/21/2025
Reactivation Date: 08/12/2025

III. Provider practice location address

16728 86 AVE
SURREY BC
V4N 5N4
CA

IV. Provider business mailing address

16728 86 AVE
SURREY BC
V4N 5N4
CA

V. Phone/Fax

Practice location:
  • Phone: 778-323-4298
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112635
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: