Katelyn Nichols

Primary specialty

DentistTaxonomy code 122300000X

License

D10277 Issued in OR

Practice address

1880 Lancaster Dr NE Ste 121
Salem, OR 97305-1069

Phone

(971) 600-3498

NPI assigned

Jul 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

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

• Arrow Dental LLC

  • General Practice Dentistry
  • Salem, OR
  • NPI 1346678877
  NPD (past)

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1073997086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 LANCASTER DR NE STE 121",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051069",
            "telephone_number": "971-600-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 LANCASTER DR NE STE 121",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051069",
            "telephone_number": "971-600-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "OR",
            "license": "D10277",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Lynn Nicholas
• Lesa Nicholes
• Carol Stevens Nicholl, LMT
• Delia Ione Nichols-Ferguson
• Erin Nichols
• Nicole Marie Nichols
• Stefani Kristine Nichols, LCSW
• Tori Nichols
• Diana Nicholson-Nelson, LCSW, MSW
• Gilbert Earl Nicholson-Nelson, M.S.W., L.C.S.W.

• Dentist in Salem, OR
• Providers in Salem, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.