Healthcare Provider Details

I. General information

NPI: 1164334686
Provider Name (Legal Business Name): NIKKI WEI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 N MAIN ST
HIGH POINT NC
27262-2643
US

IV. Provider business mailing address

8 W 3RD ST APT 902
WINSTON SALEM NC
27101-3975
US

V. Phone/Fax

Practice location:
  • Phone: 336-887-3168
  • Fax:
Mailing address:
  • Phone: 848-219-4625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number15012
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: