Healthcare Provider Details

I. General information

NPI: 1982537494
Provider Name (Legal Business Name): NANDITA CHANDRAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9955 CAMERON PARC CIR
JOHNS CREEK GA
30022-6454
US

IV. Provider business mailing address

9955 CAMERON PARC CIR
JOHNS CREEK GA
30022-6454
US

V. Phone/Fax

Practice location:
  • Phone: 404-272-9404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401420004
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: