Healthcare Provider Details

I. General information

NPI: 1720919004
Provider Name (Legal Business Name): NICKY BATTAGLIA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N MILITARY TRL STE 345
BOCA RATON FL
33431-6383
US

IV. Provider business mailing address

884 NW 6TH DR
BOCA RATON FL
33486-3504
US

V. Phone/Fax

Practice location:
  • Phone: 561-997-7500
  • Fax:
Mailing address:
  • Phone: 561-997-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number31448
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: