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General NPI Number Information
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NPI Number | 1255060083
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Entity Type | Individual
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Provider Name | JOSEPH JUSTIN MCNISH DDS
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Gender | Male
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 1800 SYRACUSE AVE
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City | NORFOLK
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State | NE
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Zip | 68701-2458
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Country | US
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Telephone | 402-371-8780
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | MARYSVILLE
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State | KS
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Zip | 66508-0386
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Country | US
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Telephone |
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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 | 7804
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License Number State | NE
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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 | 62124
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D1369
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License Number State | SD
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