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NPI Code Detail

MEDICARE: DR. NICHOLAS JOHN MINIOTIS D.D.S.

MEDICARE: DR. NICHOLAS JOHN MINIOTIS D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS024969LPA
2122300000XDentistP-138LA

General Provider Information

NPI Number : 1003881905
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS JOHN MINIOTIS D.D.S.
Provider Business Mailing Address
First Line : 1100 FLORIDA AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-2714
Country : US
Telephone Number : 504-941-8470
Fax Number : 504-941-8218
Provider Business Practice Location Address
First Line : 1100 FLORIDA AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-2714
Country : US
Telephone Number : 504-941-8470
Fax Number : 504-941-8218
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 11/05/2012

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