MEDICARE: DR. NIKKI NORTON DMD

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	122300000X	Dentist	5424	NV

General Provider Information

NPI Number	:	1740493147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIKKI NORTON DMD

Provider Business Mailing Address
First Line	:	9771 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-6800
Country	:	US
Telephone Number	:	702-616-9655
Fax Number	:	702-837-1302

Provider Business Practice Location Address
First Line	:	9771 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-6800
Country	:	US
Telephone Number	:	702-616-9655
Fax Number	:	702-837-1302

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	08/16/2012

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