Provider Demographics
NPI:1811536287
Name:KAMATH, NISHA NARAYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:NISHA
Middle Name:NARAYAN
Last Name:KAMATH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 PACIFIC ST APT 502
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3988
Mailing Address - Country:US
Mailing Address - Phone:703-989-2970
Mailing Address - Fax:
Practice Address - Street 1:7470 W 52ND AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3710
Practice Address - Country:US
Practice Address - Phone:303-854-9905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204189122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist