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NPI Code Detail

MEDICARE: NIKITA CHAUDHRI DDS

MEDICARE: NIKITA CHAUDHRI DDS
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
11223G0001XGeneral Practice Dentistry102592CA

General Provider Information

NPI Number : 1063991149
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKITA CHAUDHRI DDS
Provider Business Mailing Address
First Line : 4107 LILAC RIDGE RD
Second Line :
City : SAN RAMON
State : CA
Zip : 94582-5021
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6660 LONE TREE WAY STE 7
Second Line :
City : BRENTWOOD
State : CA
Zip : 94513-5310
Country : US
Telephone Number : 925-513-8363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2018
Last Update Date : 08/09/2018

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