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General NPI Number Information
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NPI Number | 1417719345
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Entity Type | Organization
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Legal Business Name | NICHOLS ORTHODONTICS AND AESTHETICS PLLC
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 20261 E OCOTILLO RD STE 130
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-8806
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Country | US
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Telephone | 480-442-0747
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Fax |
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Provider Business Mailing Address
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Address Line | 20261 E OCOTILLO RD STE 130
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-8806
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Country | US
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Telephone | 480-442-0747
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Fax |
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Authorized Official
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Title or Position | OWNER ORTHODONTIST
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Name | DR. TREVOR NICHOLS
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Credential | DMD, MS
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Telephone | 480-389-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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