MEDICARE: MARTIN S NAHIGIAN DDS INC

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	122300000X	Dentist	24575	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	241700	OTHER	CA	DENTI-CAL -PIN
2	B2457501	OTHER	CA	DENTI-CAL # (BILLING)
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	D2457501	OTHER	CA	DENTI-CAL # (RENDERING)
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942311568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN S NAHIGIAN DDS INC

Provider Business Mailing Address
First Line	:	1569 WEST SHAW AVENUE
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 WEST SHAW AVENUE
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	:	DENTIST
Name	:	DR. MARTIN S. NAHIGIAN
Credential	:	DDS
Telephone Number	:	559-227-8434

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/01/2008

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