Provider Demographics
NPI:1013126606
Name:VERMA, ANIL CHIKU (DDS FAGD)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:CHIKU
Last Name:VERMA
Suffix:
Gender:M
Credentials:DDS FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5660 IMPALA TRL
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-6041
Mailing Address - Country:US
Mailing Address - Phone:604-617-1974
Mailing Address - Fax:
Practice Address - Street 1:5660 IMPALA TRL
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-6041
Practice Address - Country:US
Practice Address - Phone:604-617-1974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA517821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice