Provider Demographics
NPI:1194823823
Name:SANGALANG, NILDA SALES (DDS)
Entity Type:Individual
Prefix:MRS
First Name:NILDA
Middle Name:SALES
Last Name:SANGALANG
Suffix:
Gender:F
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:PO BOX 30319
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46230-0319
Mailing Address - Country:US
Mailing Address - Phone:317-257-3321
Mailing Address - Fax:317-254-0596
Practice Address - Street 1:6202 NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220
Practice Address - Country:US
Practice Address - Phone:317-257-3321
Practice Address - Fax:317-254-0596
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice