Provider Demographics
NPI:1144908690
Name:CHOVATIYA, NISHANT RAJESHBHAI (DMD, MS, BDS)
Entity type:Individual
Prefix:
First Name:NISHANT
Middle Name:RAJESHBHAI
Last Name:CHOVATIYA
Suffix:
Gender:M
Credentials:DMD, MS, BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 LENA CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051-7015
Mailing Address - Country:US
Mailing Address - Phone:424-440-9770
Mailing Address - Fax:
Practice Address - Street 1:438 PARK RD
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-8687
Practice Address - Country:US
Practice Address - Phone:610-944-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044132122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist