Provider Demographics
NPI:1861027344
Name:NIMA ALEAGHA DDS INC
Entity Type:Organization
Organization Name:NIMA ALEAGHA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEAGHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-494-1831
Mailing Address - Street 1:1459 E THOUSAND OAKS BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-6223
Mailing Address - Country:US
Mailing Address - Phone:805-494-1831
Mailing Address - Fax:
Practice Address - Street 1:1459 E THOUSAND OAKS BLVD STE A1
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-6223
Practice Address - Country:US
Practice Address - Phone:805-494-1831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty