Provider Demographics
NPI:1538179049
Name:NERIKAR, VIVEK V (DMD)
Entity type:Individual
Prefix:DR
First Name:VIVEK
Middle Name:V
Last Name:NERIKAR
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 1:4019 NW 17TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3564
Mailing Address - Country:US
Mailing Address - Phone:904-553-4859
Mailing Address - Fax:
Practice Address - Street 1:175 NW 138TH TER STE 200
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32669-2091
Practice Address - Country:US
Practice Address - Phone:352-332-3080
Practice Address - Fax:352-333-3729
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN149051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice