Provider Demographics
NPI:1346454238
Name:DIXIT, NITA
Entity Type:Individual
Prefix:DR
First Name:NITA
Middle Name:
Last Name:DIXIT
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:NEETA
Other - Middle Name:VIVEK
Other - Last Name:DIXIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5522 BABCOCK AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-1531
Mailing Address - Country:US
Mailing Address - Phone:818-508-2424
Mailing Address - Fax:818-508-0422
Practice Address - Street 1:12840 RIVERSIDE DR STE 508
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-3339
Practice Address - Country:US
Practice Address - Phone:818-506-2424
Practice Address - Fax:818-763-5679
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA399531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice