Provider Demographics
NPI:1992976401
Name:KUMAR, NINA BHAGAVATH (DDS)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:BHAGAVATH
Last Name:KUMAR
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 1:235 2ND AVE
Mailing Address - Street 2:APARTMENT C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2712
Mailing Address - Country:US
Mailing Address - Phone:646-703-4953
Mailing Address - Fax:
Practice Address - Street 1:115 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1001
Practice Address - Country:US
Practice Address - Phone:212-766-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYFK0612362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist