Provider Demographics
NPI:1508272048
Name:AKHTER, NIDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIDA
Middle Name:
Last Name:AKHTER
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 1:4444 SKY HARBOR WAY APT 2202
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76155-3012
Mailing Address - Country:US
Mailing Address - Phone:630-423-6432
Mailing Address - Fax:
Practice Address - Street 1:3455 N BELT LINE RD STE 200
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-7861
Practice Address - Country:US
Practice Address - Phone:232-323-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-04
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029859122300000X
TX34710122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist