Provider Demographics
NPI:1891960126
Name:DAVE, NIPOON VIPINCHANDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIPOON
Middle Name:VIPINCHANDRA
Last Name:DAVE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 SE 9TH AVE
Mailing Address - Street 2:STE B
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4247
Mailing Address - Country:US
Mailing Address - Phone:503-648-6671
Mailing Address - Fax:
Practice Address - Street 1:324 SE 9TH AVE
Practice Address - Street 2:STE B
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4247
Practice Address - Country:US
Practice Address - Phone:503-648-6671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD90181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice