Provider Demographics
NPI:1932991916
Name:NIMALE, ARCHANA NARAYANSWAMY (RDH)
Entity type:Individual
Prefix:MRS
First Name:ARCHANA
Middle Name:NARAYANSWAMY
Last Name:NIMALE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13424 PENNSYLVANIA AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2686
Mailing Address - Country:US
Mailing Address - Phone:717-414-7573
Mailing Address - Fax:
Practice Address - Street 1:19103 BLACK MAPLE WAY
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-1675
Practice Address - Country:US
Practice Address - Phone:717-414-7573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8505124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist