Provider Demographics
NPI:1164461497
Name:PANDIT, HIMANSHU V (DDS)
Entity Type:Individual
Prefix:DR
First Name:HIMANSHU
Middle Name:V
Last Name:PANDIT
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 1:900 UNIVERSITY BLVD N
Mailing Address - Street 2:MC-75
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-9230
Mailing Address - Country:US
Mailing Address - Phone:904-253-2062
Mailing Address - Fax:904-253-1942
Practice Address - Street 1:900 UNIVERSITY BLVD N
Practice Address - Street 2:DENTAL ADMINISTRATION MC-77
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-9230
Practice Address - Country:US
Practice Address - Phone:904-253-2683
Practice Address - Fax:904-632-5320
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN94711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice