Healthcare Provider Details

I. General information

NPI: 1245185172
Provider Name (Legal Business Name): KIRIL VLADE NIKOLOVSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 S COLUMBIA ST
CHAPEL HILL NC
27514-4309
US

IV. Provider business mailing address

385 S COLUMBIA ST
CHAPEL HILL NC
27514-4309
US

V. Phone/Fax

Practice location:
  • Phone: 708-712-4196
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number14779
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: