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Individual

ANGELI JAYESH THAKKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
11511 S 42ND ST, BELLEVUE, NE 68123-1026
(402) 291-5400
(402) 291-5401
Mailing address
11511 S 42ND ST, BELLEVUE, NE 68123-1026
(402) 291-5400
(402) 291-5401

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6301
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1-002-526-5400
NE
Enumeration date
09/01/2005
Last updated
07/28/2023
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