=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295692994
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SEOK W NICHOLS, DDS, PS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2026
-----------------------------------------------------
Last Update Date | 01/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5050 STATE HIGHWAY 303 NE STE 123
-----------------------------------------------------
City | BREMERTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98311-3694
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-377-9800
-----------------------------------------------------
Fax | 360-288-4955
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5050 STATE HIGHWAY 303 NE STE 123
-----------------------------------------------------
City | BREMERTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98311-3694
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-377-9800
-----------------------------------------------------
Fax | 360-288-4955
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SEOK WHAN NICHOLS
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 360-271-1309
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------