Provider Demographics
NPI:1225368376
Name:GIH, NICHOLAS ADAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ADAM
Last Name:GIH
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 1:231 N INDIAN HILL BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4648
Mailing Address - Country:US
Mailing Address - Phone:909-624-7865
Mailing Address - Fax:909-626-0014
Practice Address - Street 1:231 N INDIAN HILL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4648
Practice Address - Country:US
Practice Address - Phone:909-624-7865
Practice Address - Fax:909-626-0014
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA589221223G0001X
TX295331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1225368376OtherUS ARMY