Healthcare Provider Details

I. General information

NPI: 1194929836
Provider Name (Legal Business Name): JULIE Q NIES D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 S STATE ST
DOVER DE
19901-4946
US

IV. Provider business mailing address

272 ROCKLAND DR
WYOMING DE
19934-3680
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-8000
  • Fax: 302-674-8005
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberG1-0001254
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberG3-0000342
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: