Provider Demographics
NPI:1225294390
Name:RASHMI M NANDISH, D.D.S., P.A
Entity Type:Organization
Organization Name:RASHMI M NANDISH, D.D.S., P.A
Other - Org Name:LAKEVIEW DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHMI
Authorized Official - Middle Name:M
Authorized Official - Last Name:NANDISH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-558-6315
Mailing Address - Street 1:12002 RICHMOND AVE STE 1100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2560
Mailing Address - Country:US
Mailing Address - Phone:281-558-6315
Mailing Address - Fax:281-558-6970
Practice Address - Street 1:12002 RICHMOND AVE STE 1100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2560
Practice Address - Country:US
Practice Address - Phone:281-558-6315
Practice Address - Fax:281-558-6970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17339801Medicaid