Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 0024325 | TX |
NPI | 1043465925 |
---|---|
Provider Name | Dr. Nina S Khedkar |
First Address | Plano, TX 75074-5551 |
Second Address | Fort Worth, TX 76132-3281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2008 |
Last Update Date | 19/11/2008 |