Provider Demographics
NPI:1497892590
Name:SCHORT, NANCY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:S
Last Name:SCHORT
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 1:270 26TH ST
Mailing Address - Street 2:SUITE #301
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-2566
Mailing Address - Country:US
Mailing Address - Phone:310-394-2796
Mailing Address - Fax:310-829-9137
Practice Address - Street 1:270 26TH ST
Practice Address - Street 2:SUITE #301
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90402-2566
Practice Address - Country:US
Practice Address - Phone:310-394-2796
Practice Address - Fax:310-829-9137
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice