Provider Demographics
NPI:1245570480
Name:NGAKA, INIVA RYTA (DMD)
Entity Type:Individual
Prefix:DR
First Name:INIVA
Middle Name:RYTA
Last Name:NGAKA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 WALDO AVE
Mailing Address - Street 2:APT 1G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2247
Mailing Address - Country:US
Mailing Address - Phone:859-420-0385
Mailing Address - Fax:
Practice Address - Street 1:3636 WALDO AVE
Practice Address - Street 2:APT # 1G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2247
Practice Address - Country:US
Practice Address - Phone:859-420-0385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0574151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice