Provider Demographics
NPI:1295624278
Name:CHAUDHARI, NISHI HARSHAD (DDS)
Entity type:Individual
Prefix:
First Name:NISHI
Middle Name:HARSHAD
Last Name:CHAUDHARI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 W BROADWAY AVE APT 211
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-1241
Mailing Address - Country:US
Mailing Address - Phone:248-797-0079
Mailing Address - Fax:
Practice Address - Street 1:7410 MCCART AVE STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-7427
Practice Address - Country:US
Practice Address - Phone:817-529-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX416931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice