Organization
NIRUYISPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM NIRUYI DDS (PRESIDENT)
(602) 320-0246
Entity
Organization
Contact information
Practice address
3037 MARTHA DR, VENTURA, CA 93003-2934
(805) 656-6911
(805) 643-2671
Mailing address
3037 MARTHA DR, VENTURA, CA 93003-2934
(805) 656-6911
(805) 643-2671
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D5292
AZ
302F00000X
Exclusive Provider Organization
Primary
56796
CA
Other
Enumeration date
10/25/2006
Last updated
05/08/2011
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