Healthcare Provider Details

I. General information

NPI: 1396423893
Provider Name (Legal Business Name): ANDREW NAZHA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 BETHEL RD
SOMERS POINT NJ
08244-1601
US

IV. Provider business mailing address

345 E 24TH ST
NEW YORK NY
10010-4020
US

V. Phone/Fax

Practice location:
  • Phone: 609-904-5146
  • Fax:
Mailing address:
  • Phone: 212-998-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03144100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: