Individual
NAKITA SHANAY FORDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
341 PONCE DE LEON AVE NE, ATLANTA, GA 30308-2012
(404) 616-0414
Mailing address
101 ATHENS WAY APT 474, NASHVILLE, TN 37228-1666
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223G0001X
GA
Other
Enumeration date
05/30/2026
Last updated
05/30/2026
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