Provider Demographics
NPI:1851460976
Name:FRIDMAN, NINA (DDS)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:FRIDMAN
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 1:4073 CAMELLIA AVE
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3007
Mailing Address - Country:US
Mailing Address - Phone:213-864-2503
Mailing Address - Fax:
Practice Address - Street 1:747 E ALTADENA DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2302
Practice Address - Country:US
Practice Address - Phone:626-794-8133
Practice Address - Fax:626-794-9163
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist