Provider Demographics
NPI:1316297708
Name:NIKKHAH, SAMIA (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMIA
Middle Name:
Last Name:NIKKHAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11400 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE#510
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3004
Mailing Address - Country:US
Mailing Address - Phone:301-979-9071
Mailing Address - Fax:301-979-9271
Practice Address - Street 1:11400 ROCKVILLE PIKE
Practice Address - Street 2:SUITE # 510
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-3004
Practice Address - Country:US
Practice Address - Phone:301-979-9071
Practice Address - Fax:301-979-9271
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15194122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist