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NIVA DENTAL SPECIALISTS PLLC NPI 1194436634


NPI Information

NPI: 1194436634
Provider Name: NIVA DENTAL SPECIALISTS PLLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
15141 RONALD REAGAN BLVD
SUITE 516
LEANDER, TX
ZIP 78641
Phone: (512) 881-8852
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NIVA DENTAL SPECIALISTS PLLC is an oral and maxillofacial surgery dentist in Leander, TX. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. NIVA DENTAL SPECIALISTS PLLC NPI is 1194436634. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

15141 RONALD REAGAN BLVD
SUITE 516
LEANDER, TX
ZIP 78641-864
Phone: (512) 881-8852
Fax: (512) 881-7721

The provider's authorized official is Shouvik Ponnusamy .
The authorized official title is Owner and has the following contact phone number (630) 267-1199.

The enumeration date for this NPI number is 12/6/2022 and was last updated on 12/6/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223E0200XDentistEndodonticsNo
21223P0300XDentistPeriodonticsNo
31223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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