Provider Demographics
NPI:1154523181
Name:PACHECO, NIURKA R (DDS)
Entity type:Individual
Prefix:DR
First Name:NIURKA
Middle Name:R
Last Name:PACHECO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:803 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5613
Mailing Address - Country:US
Mailing Address - Phone:201-833-0666
Mailing Address - Fax:201-833-0832
Practice Address - Street 1:803 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5613
Practice Address - Country:US
Practice Address - Phone:201-833-0666
Practice Address - Fax:201-833-0832
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI170211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry