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General NPI Number Information
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NPI Number | 1497426183
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Entity Type | Individual
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Provider Name | NICHOLAS ROBERT ROMANS DMD, MSD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 21083 N JOHN WAYNE PKWY
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City | MARICOPA
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State | AZ
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Zip | 85139-2959
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Country | US
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Telephone | 623-343-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 6319 E WALTANN LN
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1945
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Country | US
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Telephone | 620-205-9494
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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 | D012045
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D012045
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License Number State | AZ
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