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NPI Code Detail

MEDICARE: DR. NISHTHA VINIAK DDS

MEDICARE: DR. NISHTHA VINIAK 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
1122300000XDentistIL

General Provider Information

NPI Number : 1184826174
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NISHTHA VINIAK DDS
Provider Business Mailing Address
First Line : 802 W UNIVERSITY LN APT 1A
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1062
Country : US
Telephone Number : 773-704-1974
Fax Number :
Provider Business Practice Location Address
First Line : 654 E 47TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60653-4224
Country : US
Telephone Number : 773-624-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2007
Last Update Date : 07/08/2007

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Directions to “ DR. NISHTHA VINIAK DDS” Practice Location

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