Provider Demographics
NPI:1326369042
Name:NIJHAWAN, SUMIT (DDS, MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:SUMIT
Middle Name:
Last Name:NIJHAWAN
Suffix:
Gender:M
Credentials:DDS, MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SOUTH DR STE 130
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4317
Mailing Address - Country:US
Mailing Address - Phone:650-938-7703
Mailing Address - Fax:
Practice Address - Street 1:105 SOUTH DR STE 130
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4317
Practice Address - Country:US
Practice Address - Phone:650-938-7703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA644211223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery