Healthcare Provider Details

I. General information

NPI: 1265363824
Provider Name (Legal Business Name): MONISH NANDU DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 STATE ST
SCHENECTADY NY
12304-2610
US

IV. Provider business mailing address

11007 KENTMERE CT
WINDERMERE FL
34786-5417
US

V. Phone/Fax

Practice location:
  • Phone: 540-588-0853
  • Fax:
Mailing address:
  • Phone: 407-616-7013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: