Provider Demographics
NPI:1073899332
Name:NYATHI DENTAL HEALTH LLC
Entity Type:Organization
Organization Name:NYATHI DENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMBARASHE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIRENYATWA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-449-5540
Mailing Address - Street 1:8775 CLOUDLEAP CT
Mailing Address - Street 2:SUITE 236
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3044
Mailing Address - Country:US
Mailing Address - Phone:410-599-5214
Mailing Address - Fax:410-522-5030
Practice Address - Street 1:8775 CLOUDLEAP CT
Practice Address - Street 2:SUITE 236
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3044
Practice Address - Country:US
Practice Address - Phone:410-599-5214
Practice Address - Fax:410-522-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty