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General NPI Number Information
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NPI Number | 1508500984
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Entity Type | Individual
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Provider Name | NICOLE YOUD DDS
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | VCUHS DEPT OF ORAL AND MAXILLOFACIAL SURGERY 1250 E. MARSHALL STREET
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City | RICHMOND
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State | VA
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Zip | 23298-0566
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Country | US
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Telephone | 804-828-0602
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Fax |
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Provider Business Mailing Address
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Address Line | 1814 SAINT ANDREWS BLVD
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City | PANAMA CITY
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State | FL
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Zip | 32405-2838
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Country | US
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Telephone | 850-215-0798
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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 | DN31643
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License Number State | FL
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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 | 0442000451
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN124049
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License Number State | GA
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