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General NPI Number Information
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NPI Number | 1215419338
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Entity Type | Individual
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Provider Name | NADIA KIESEL NEWMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 1280 WESTERN BLVD UNIT 200
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City | JACKSONVILLE
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State | NC
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Zip | 28546-7658
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Country | US
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Telephone | 910-388-0223
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Fax |
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Provider Business Mailing Address
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Address Line | 619 WHITE OAK XING
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City | SWANSBORO
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State | NC
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Zip | 28584-8479
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Country | US
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Telephone | 619-846-2853
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10964686-9921
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13101
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License Number State | NC
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