Provider Demographics
NPI:1043042245
Name:NYAIGOTI, DENNIS
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:NYAIGOTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8962 GENERATIONS CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1238
Mailing Address - Country:US
Mailing Address - Phone:407-719-9949
Mailing Address - Fax:
Practice Address - Street 1:8962 GENERATIONS CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-1238
Practice Address - Country:US
Practice Address - Phone:407-719-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95175724163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse