Provider Demographics
NPI:1932125499
Name:NEHAWANDIAN, NANCY (DDS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NEHAWANDIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:FATHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:250 BLOSSOM HILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-4420
Mailing Address - Country:US
Mailing Address - Phone:408-354-5600
Mailing Address - Fax:408-354-5432
Practice Address - Street 1:250 BLOSSOM HILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-4420
Practice Address - Country:US
Practice Address - Phone:408-354-5600
Practice Address - Fax:408-354-5432
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA378831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice