Provider Demographics
NPI:1447450283
Name:GOYAL, NITIKA K (DDS)
Entity type:Individual
Prefix:DR
First Name:NITIKA
Middle Name:K
Last Name:GOYAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MAPLE ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2571
Mailing Address - Country:US
Mailing Address - Phone:908-598-0050
Mailing Address - Fax:908-598-0051
Practice Address - Street 1:47 MAPLE ST
Practice Address - Street 2:SUITE 305
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2571
Practice Address - Country:US
Practice Address - Phone:908-598-0050
Practice Address - Fax:908-598-0051
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023469001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics