Provider Demographics
NPI:1881718161
Name:JAIN, SAMBHAV NATH (DMD)
Entity type:Individual
Prefix:DR
First Name:SAMBHAV
Middle Name:NATH
Last Name:JAIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 KLAMT CT
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-9278
Mailing Address - Country:US
Mailing Address - Phone:530-852-0756
Mailing Address - Fax:
Practice Address - Street 1:727 COLUSA AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3943
Practice Address - Country:US
Practice Address - Phone:530-751-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice