Active NPI
Justin William Nichols, D.D.S.
- Student in an Organized Health Care Education/Training Program
- Iowa City, IA
National Provider Identifier
1003367293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 10081
- Practice address
- 801 Newton Rd
Iowa City, IA 52242-1001 - Phone
- (319) 335-7440
- Fax
- (319) 335-7451
- NPI assigned
- Oct 22, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 100587 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 10081 | IA | Primary |
Addresses
Primary practice location
801 Newton Rd
Iowa City, IA 52242-1001
Mailing address
322 Dental Science BLDG S
Iowa City, IA 52242-1001
Phone (319) 335-7440
Other practice location 1
1660 S Columbian Way
Seattle, WA 98108-1532
Phone (909) 437-6400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100587 | CA | MD | Dentist |
| 10081 | IA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1003367293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 DENTAL SCIENCE BLDG S",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421001",
"telephone_number": "319-335-7440",
"fax_number": "319-335-7451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 NEWTON RD",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522421001",
"telephone_number": "319-335-7440",
"fax_number": "319-335-7451"
}
],
"practiceLocations": [
{
"address_1": "1660 S Columbian Way",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981081532",
"country_code": "US",
"telephone_number": "909-437-6400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICHOLS",
"first_name": "JUSTIN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-22",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "100587",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IA",
"license": "10081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Iowa City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.