Provider Demographics
NPI:1134623523
Name:PALANKER, NATHAN DANIEL (DDS, MS)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:DANIEL
Last Name:PALANKER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-5250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:299 JUANA AVE STE C
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4838
Practice Address - Country:US
Practice Address - Phone:510-352-6266
Practice Address - Fax:510-352-6392
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX337921223P0300X
CA1037621223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics