Provider Demographics
NPI:1487874517
Name:VEENA NANDA DMD LLC
Entity type:Organization
Organization Name:VEENA NANDA DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:NANDA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS PHD
Authorized Official - Phone:860-528-5878
Mailing Address - Street 1:593 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:E HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108
Mailing Address - Country:US
Mailing Address - Phone:860-528-5878
Mailing Address - Fax:860-282-7981
Practice Address - Street 1:593 BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:E HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108
Practice Address - Country:US
Practice Address - Phone:860-528-5878
Practice Address - Fax:860-282-7981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty