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General NPI Number Information
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NPI Number | 1962295766
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Entity Type | Individual
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Provider Name | ARTEM NIKULIN DDS
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Gender | Male
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Dates
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Enumeration Date | 05/24/2025
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Last Update Date | 05/24/2025
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Provider Practice Location Address
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Address Line | 8511 JEFFERSON LN N
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City | MINNEAPOLIS
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State | MN
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Zip | 55445-2121
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Country | US
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Telephone | 763-205-0526
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 29TH AVE SE APT C
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-2742
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Country | US
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Telephone |
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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 | D15260
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License Number State | MN
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