Provider Demographics
NPI:1902245491
Name:NANA, KAVITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:
Last Name:NANA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KAVITA
Other - Middle Name:NANA
Other - Last Name:BHAGCHANDANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:57 E DOWNER PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-3340
Mailing Address - Country:US
Mailing Address - Phone:630-859-8686
Mailing Address - Fax:
Practice Address - Street 1:57 E DOWNER PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-3340
Practice Address - Country:US
Practice Address - Phone:630-859-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011995A122300000X
IL019029852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist