Provider Demographics
NPI:1477966810
Name:GOYAL, NIKITA (DDS)
Entity Type:Individual
Prefix:
First Name:NIKITA
Middle Name:
Last Name:GOYAL
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 1:8310 PALOMAS AVE NE STE C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5286
Mailing Address - Country:US
Mailing Address - Phone:505-881-0334
Mailing Address - Fax:505-881-8157
Practice Address - Street 1:8310 PALOMAS AVE NE STE C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5286
Practice Address - Country:US
Practice Address - Phone:505-881-0334
Practice Address - Fax:505-881-8157
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD4094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist