MEDICARE: DR. NICHOLAS PERRY ORCHARD DDS

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	20210	TX

General Provider Information

NPI Number	:	1801017553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS PERRY ORCHARD DDS

Provider Business Mailing Address
First Line	:	6421 SARATOGA BLVD BLDG 102
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-3480
Country	:	US
Telephone Number	:	361-992-3011
Fax Number	:	361-992-8417

Provider Business Practice Location Address
First Line	:	6421 SARATOGA BLVD BLDG 102
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-3480
Country	:	US
Telephone Number	:	361-992-3011
Fax Number	:	361-992-8417

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	05/27/2026

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