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General NPI Number Information
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NPI Number | 1235773508
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Entity Type | Organization
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Legal Business Name | DHANASHRI NANDAVIKAR, DDS, INC.
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 2669A CROPLEY AVE
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City | SAN JOSE
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State | CA
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Zip | 95132-3707
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Country | US
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Telephone | 408-942-0469
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Fax |
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Provider Business Mailing Address
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Address Line | 784 NODAWAY AVE
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City | FREMONT
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State | CA
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Zip | 94539-7544
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Country | US
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Telephone | 650-215-3058
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. DHANASHRI NANDAVIKAR
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Credential |
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Telephone | 650-215-3058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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