Provider Demographics
NPI:1174540082
Name:VAKHARIA, NISHI H (DDS)
Entity type:Individual
Prefix:DR
First Name:NISHI
Middle Name:H
Last Name:VAKHARIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SIRINGO RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5709
Mailing Address - Country:US
Mailing Address - Phone:505-983-6153
Mailing Address - Fax:505-983-8132
Practice Address - Street 1:125 SIRINGO RD
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5709
Practice Address - Country:US
Practice Address - Phone:505-983-6153
Practice Address - Fax:505-983-8132
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD22961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice