Nicholas Bahls, DDS
Individual provider Active NPI Dentist · Rochester, MN
NPI 1013758663 · NPPES record last updated Jun 5, 2024
Key facts
- NPI
- 1013758663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D15090 (MN)
- Practice address
- 1008 12TH St SE
Rochester, MN 55904-5030 - Phone
- (507) 282-6448
- NPI assigned
- Jun 5, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D15090 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 12TH Street Dental Office PA | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D15090 | MN | Yes |
Addresses
Primary practice location
1008 12TH St SE
Rochester, MN 55904-5030
Mailing address
1008 12TH St SE
Rochester, MN 55904-5030
Phone (507) 282-6448
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.