Provider Demographics
NPI:1861780181
Name:NAYYAR, AMIT (DDS)
Entity type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:NAYYAR
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 1:9870 SIERRA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-1713
Mailing Address - Country:US
Mailing Address - Phone:909-239-0680
Mailing Address - Fax:
Practice Address - Street 1:9870 SIERRA AVE STE B
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-1713
Practice Address - Country:US
Practice Address - Phone:909-239-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190287781223G0001X
CA631231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice