Provider Demographics
NPI:1245453281
Name:NAIK, SAMIR JANAK (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:JANAK
Last Name:NAIK
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 1:9105 CLUB HILL DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8433
Mailing Address - Country:US
Mailing Address - Phone:571-331-6962
Mailing Address - Fax:
Practice Address - Street 1:987 EAST ST
Practice Address - Street 2:SUITE H
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-8858
Practice Address - Country:US
Practice Address - Phone:919-545-9500
Practice Address - Fax:919-542-0904
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA 89621223G0001X
VA08010049621223G0001X
NC9478122300000X
DC1000741122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist