Nickolaus M. Weiss, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12011545A Issued in IN

Practice address

1842 Steven Ave
Bedford, IN 47421-3500

Phone

(812) 279-9767

Fax

(812) 279-5971

NPI assigned

Jul 17, 2008

Last updated

Oct 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dogwood Dental LLC

  • Dental Clinic/Center
  • Orleans, IN
  • NPI 1407479058
  NPD Authorized official
• License to Drill LLC

  dba Atrium Dental Bloomington

  • Dental Clinic/Center
  • Bloomington, IN
  • NPI 1639057789
  NPD Authorized official
• MFDC of Indiana, Inc

  dba Gentle Dentist - Edgewood

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1306331905
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1013171156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 STEVEN AVE",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213500",
            "telephone_number": "262-227-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 STEVEN AVE",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213500",
            "telephone_number": "812-279-9767",
            "fax_number": "812-279-5971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 E Winslow Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474018657",
            "country_code": "US",
            "telephone_number": "812-337-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEISS",
        "first_name": "NICKOLAUS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011545A",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "WI6335",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Bedford, IN
• Providers in Bedford, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.