MEDICARE: NICKOU MEMARI

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
1	1223G0001X	General Practice Dentistry	600218715	WI

General Provider Information

NPI Number	:	1164352688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICKOU MEMARI

Provider Business Mailing Address
First Line	:	3518 SOUTHWOOD CT
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-6963
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3216 BUSINESS PARK DR
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54482-8838
Country	:	US
Telephone Number	:	715-544-1277
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/26/2026

Similar Medicare Providers

1770876807 — SHANA ALEXIS FRANCOIS D.D.S
Practice Location Address:

3216 BUSINESS PARK DR
STEVENS POINT, WI
54482-8838

Practice Phone: 715-544-1277
Practice Fax:

1821477530 — DR. KIMBERLY KUTZLER D.D.S.
Practice Location Address:

3216 BUSINESS PARK DR
STEVENS POINT, WI
54482-8838

Practice Phone: 715-544-1277
Practice Fax:

1790298651 — POINT PLACE DENTAL, LLC
Practice Location Address:

3216 BUSINESS PARK DR
STEVENS POINT, WI
54482-8838

Practice Phone: 715-952-9664
Practice Fax:

1194859199 — TARA LYNN JENNINGS DDS
Practice Location Address:

3216 BUSINESS PARK DR
STEVENS POINT, WI
54481-8838

Practice Phone: 715-341-7171
Practice Fax: 715-341-5160

1164669958 — MRS. JENNY LYNN MAVES RDH
Practice Location Address:

3216 BUSINESS PARK DR
STEVENS POINT, WI
54481-8838

Practice Phone: 715-346-0000
Practice Fax:

1902045214 — DENISE MARIE TURK RDH
Practice Location Address:

3216 BUSINESS PARK DR
STEVENS POINT, WI
54481-8838

Practice Phone: 715-346-0000
Practice Fax:

Directions to “ NICKOU MEMARI ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.