Healthcare Provider Details

I. General information

NPI: 1467620922
Provider Name (Legal Business Name): JAMES E. NICHOLLS, DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2008
Last Update Date: 02/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 SCHROCK RD
COLUMBUS OH
43229-1575
US

IV. Provider business mailing address

1730 SCHROCK RD
COLUMBUS OH
43229-1575
US

V. Phone/Fax

Practice location:
  • Phone: 614-890-1333
  • Fax: 614-890-4945
Mailing address:
  • Phone: 614-890-1333
  • Fax: 614-890-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30016245
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30022403
License Number StateOH

VIII. Authorized Official

Name: DR. JAMES E NICHOLLS
Title or Position: PRESIDENT
Credential: D.D.S
Phone: 614-890-1333