Provider Demographics
NPI:1962589069
Name:GROVES, NADIA A (DMD)
Entity type:Individual
Prefix:DR
First Name:NADIA
Middle Name:A
Last Name:GROVES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:NADIA
Other - Middle Name:A
Other - Last Name:GROVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:14815 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2027
Mailing Address - Country:US
Mailing Address - Phone:215-432-1776
Mailing Address - Fax:
Practice Address - Street 1:14815 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2027
Practice Address - Country:US
Practice Address - Phone:215-432-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC80941223G0001X
NV59751223G0001X
FLDN239791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice