Provider Demographics
NPI:1578631164
Name:NANDA, VEENA (DMD MS PH D)
Entity Type:Individual
Prefix:DR
First Name:VEENA
Middle Name:
Last Name:NANDA
Suffix:
Gender:F
Credentials:DMD MS PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 BURNSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:E HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108
Mailing Address - Country:US
Mailing Address - Phone:860-528-5878
Mailing Address - Fax:860-282-7981
Practice Address - Street 1:593 BURNSIDE AVENUE
Practice Address - Street 2:
Practice Address - City:E HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108
Practice Address - Country:US
Practice Address - Phone:860-528-5878
Practice Address - Fax:860-282-7981
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4788122300000X
NY049009122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist