MEDICARE: NISHI HARSHAD CHAUDHARI 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
1	1223G0001X	General Practice Dentistry	41693	TX

General Provider Information

NPI Number	:	1295624278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISHI HARSHAD CHAUDHARI DDS

Provider Business Mailing Address
First Line	:	218 W BROADWAY AVE APT 211
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-1241
Country	:	US
Telephone Number	:	248-797-0079
Fax Number	:

Provider Business Practice Location Address
First Line	:	7410 MCCART AVE STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-7427
Country	:	US
Telephone Number	:	817-529-6300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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