Provider Demographics
NPI:1528642261
Name:TISHLER, NADIA NICOLE (DDS)
Entity type:Individual
Prefix:DR
First Name:NADIA
Middle Name:NICOLE
Last Name:TISHLER
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 1:7011 RIBELIN RANCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8585
Mailing Address - Country:US
Mailing Address - Phone:512-517-0505
Mailing Address - Fax:
Practice Address - Street 1:7011 RIBELIN RANCH RD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-8585
Practice Address - Country:US
Practice Address - Phone:512-517-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX38370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program