Individual
NIKITA KUPPANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21116 N JOHN WAYNE PKWY STE B7, MARICOPA, AZ 85139-2932
(520) 568-3828
(520) 568-0443
Mailing address
21116 N JOHN WAYNE PKWY STE B7, MARICOPA, AZ 85139-2932
(520) 568-3828
(520) 568-0443
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD4368
NM
1223P0221X
Pediatric Dentistry
Primary
10316
AZ
Other
Enumeration date
09/08/2015
Last updated
01/19/2024
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