Provider Demographics
NPI:1598041535
Name:HAN & NIGAM DMD PLLC
Entity Type:Organization
Organization Name:HAN & NIGAM DMD PLLC
Other - Org Name:BELLASMILES OF PUYALLUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HIMANSHU
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-845-7645
Mailing Address - Street 1:2321 MERIDIAN ST S
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-1554
Mailing Address - Country:US
Mailing Address - Phone:253-845-7645
Mailing Address - Fax:253-840-5599
Practice Address - Street 1:2321 MERIDIAN ST S
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-1554
Practice Address - Country:US
Practice Address - Phone:253-845-7645
Practice Address - Fax:253-840-5599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 0091431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty