Healthcare Provider Details

I. General information

NPI: 1740179563
Provider Name (Legal Business Name): NISHA ZAVER DDS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 MADISON ST STE 100
CLARKSVILLE TN
37043-5024
US

IV. Provider business mailing address

816 BURLINGTON CT
CLARKSVILLE TN
37043-8913
US

V. Phone/Fax

Practice location:
  • Phone: 931-202-9151
  • Fax:
Mailing address:
  • Phone: 931-302-3279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12808
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: