Provider Demographics
NPI:1528229234
Name:NAIK, AMISH ISHVAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMISH
Middle Name:ISHVAR
Last Name:NAIK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 GEORGIAN PARK
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-6968
Mailing Address - Country:US
Mailing Address - Phone:770-487-5346
Mailing Address - Fax:770-631-3745
Practice Address - Street 1:1601 GEORGIAN PARK
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6968
Practice Address - Country:US
Practice Address - Phone:770-487-5346
Practice Address - Fax:770-631-3745
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0137521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice