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NPI Code Detail

MEDICARE: DR. NINA S KHEDKAR DMD

MEDICARE: DR. NINA S KHEDKAR DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry0024325TX

General Provider Information

NPI Number : 1043465925
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NINA S KHEDKAR DMD
Provider Business Mailing Address
First Line : 840 CENTRAL PKWY E
Second Line : SUITE 100
City : PLANO
State : TX
Zip : 75074-5551
Country : US
Telephone Number : 972-633-2775
Fax Number : 469-361-4700
Provider Business Practice Location Address
First Line : 5500 OVERTON RIDGE BLVD
Second Line : SUITE 228
City : FORT WORTH
State : TX
Zip : 76132-3281
Country : US
Telephone Number : 972-578-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2008
Last Update Date : 11/19/2008

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