Provider Demographics
NPI:1669888004
Name:NANDA, PATRICIA MCCLORY (DMD, MPH)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MCCLORY
Last Name:NANDA
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 KINGSBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-3730
Mailing Address - Country:US
Mailing Address - Phone:907-821-1992
Mailing Address - Fax:
Practice Address - Street 1:2111 KINGSBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-3730
Practice Address - Country:US
Practice Address - Phone:907-821-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist