Provider Demographics
NPI:1205042116
Name:NALCHAJIAN, NICOLE ELISE (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:ELISE
Last Name:NALCHAJIAN
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7501 N FRESNO ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2458
Mailing Address - Country:US
Mailing Address - Phone:559-432-7100
Mailing Address - Fax:559-432-8620
Practice Address - Street 1:7501 N FRESNO ST
Practice Address - Street 2:SUITE 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2458
Practice Address - Country:US
Practice Address - Phone:559-432-7100
Practice Address - Fax:559-432-8620
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA447451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics