Provider Demographics
NPI:1841637212
Name:WENDOVER, NINEL (DDS)
Entity type:Individual
Prefix:
First Name:NINEL
Middle Name:
Last Name:WENDOVER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NINEL
Other - Middle Name:
Other - Last Name:OTVERTCHENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:237 ROMBOUT RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-7850
Mailing Address - Country:US
Mailing Address - Phone:845-797-9572
Mailing Address - Fax:
Practice Address - Street 1:237 ROMBOUT RD
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12569-7850
Practice Address - Country:US
Practice Address - Phone:845-797-9572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-26
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program