Provider Demographics
NPI:1275781056
Name:NANDA, RUCHI (DDS, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:RUCHI
Middle Name:
Last Name:NANDA
Suffix:
Gender:F
Credentials:DDS, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17200 N MAY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-9031
Mailing Address - Country:US
Mailing Address - Phone:405-330-9911
Mailing Address - Fax:405-330-3960
Practice Address - Street 1:17200 N MAY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-9031
Practice Address - Country:US
Practice Address - Phone:405-330-9911
Practice Address - Fax:405-330-3960
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK043021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics