Provider Demographics
NPI:1760471353
Name:ANDREWS, NAHIDH DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:NAHIDH
Middle Name:DAVID
Last Name:ANDREWS
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 1:3332 PORTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-3656
Mailing Address - Country:US
Mailing Address - Phone:574-273-3900
Mailing Address - Fax:574-273-3335
Practice Address - Street 1:3332 PORTAGE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-3656
Practice Address - Country:US
Practice Address - Phone:574-273-3900
Practice Address - Fax:574-273-3335
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010717A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice