MEDICARE: MARTIN SIMON NAHIGIAN 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	24575	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750515656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN SIMON NAHIGIAN DDS

Provider Business Mailing Address
First Line	:	1569 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3503
Country	:	US
Telephone Number	:	559-227-8434
Fax Number	:	559-227-6246

Provider Business Practice Location Address
First Line	:	1569 W SHAW AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3503
Country	:	US
Telephone Number	:	559-227-8434
Fax Number	:	559-227-6246

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

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	06/16/2016

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