Provider Demographics
NPI:1699396846
Name:NIHAR D TANNA DDS MS INCORPORATED
Entity Type:Organization
Organization Name:NIHAR D TANNA DDS MS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIHAR
Authorized Official - Middle Name:D
Authorized Official - Last Name:TANNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MSINC
Authorized Official - Phone:909-464-9348
Mailing Address - Street 1:27035 BIG HORN MOUNTAIN WAY
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-4211
Mailing Address - Country:US
Mailing Address - Phone:909-753-8215
Mailing Address - Fax:
Practice Address - Street 1:14232 SCHLEISMAN RD STE 220
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-4021
Practice Address - Country:US
Practice Address - Phone:909-464-9348
Practice Address - Fax:909-464-9349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty