Provider Demographics
NPI:1013771252
Name:PATNANA, RADHIKA NIKITA (RDH, MIB, BS)
Entity Type:Individual
Prefix:
First Name:RADHIKA
Middle Name:NIKITA
Last Name:PATNANA
Suffix:
Gender:F
Credentials:RDH, MIB, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 QUITMAN ST UNIT 403
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-7645
Mailing Address - Country:US
Mailing Address - Phone:832-819-1688
Mailing Address - Fax:
Practice Address - Street 1:102 QUITMAN ST UNIT 403
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-7645
Practice Address - Country:US
Practice Address - Phone:832-819-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24644124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty