Healthcare Provider Details

I. General information

NPI: 1689631962
Provider Name (Legal Business Name): NICHOLAS A NARDUCCI D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 SW 22ND PL STE 102
OCALA FL
34471-7754
US

IV. Provider business mailing address

2130 SW 22ND PL STE 102
OCALA FL
34471-7754
US

V. Phone/Fax

Practice location:
  • Phone: 352-624-9600
  • Fax: 352-624-9600
Mailing address:
  • Phone: 352-624-9600
  • Fax: 352-624-9600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112884
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN15716
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: