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General NPI Number Information
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NPI Number | 1376920785
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Entity Type | Individual
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Provider Name | NICHOLAS NAGAKI DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 148 EAST AVE STE 2J
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City | NORWALK
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State | CT
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Zip | 06851-5727
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Country | US
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Telephone | 203-866-0061
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Fax |
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Provider Business Mailing Address
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Address Line | 3701 S CLARKSON ST STE 300
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City | ENGLEWOOD
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State | CO
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Zip | 80113-3960
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Country | US
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Telephone | 720-254-3746
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DEN.00204192
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 13939
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License Number State | CT
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