1699396846 NPI number — NIHAR D TANNA DDS MS INCORPORATED

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699396846 NPI number — NIHAR D TANNA DDS MS INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NIHAR D TANNA DDS MS INCORPORATED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699396846
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27035 BIG HORN MOUNTAIN WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORBA LINDA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92887-4211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-753-8215
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14232 SCHLEISMAN RD STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTVALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92880-4021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-464-9348
Provider Business Practice Location Address Fax Number:
909-464-9349
Provider Enumeration Date:
04/29/2020

Additional Information

Authorized Official

Authorized Official Last Name:
TANNA
Authorized Official First Name:
NIHAR
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
909-464-9348

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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