Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 1728 | FL |
NPI | 1083136295 |
---|---|
Provider Name | Nikki Darbani |
First Address | Jacksonville, FL 32257-8206 |
Second Address | Orange Park, FL 32073-4502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2017 |
Last Update Date | 02/09/2020 |