Healthcare Provider Details

I. General information

NPI: 1982958930
Provider Name (Legal Business Name): NAMRATA NAYYAR BDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE UCSF DENTAL SCHOOL, RM 3252
SAN FRANCISCO CA
94143-0758
US

IV. Provider business mailing address

8 LOCKSLEY AVE APT 10 L
SAN FRANCISCO CA
94122-3855
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9884
  • Fax:
Mailing address:
  • Phone: 415-476-9884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberSP265
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberF28509
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: