Active NPI
Nicholas George Ressel, D.M.D.
- Dentist
- Parris Island, SC
National Provider Identifier
1093060410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 19868
- Practice address
- 674 Boulevard de France,
Parris Island, SC 29905 - Phone
- (843) 228-3500
- NPI assigned
- Jul 23, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN 19868 | FL | Primary |
Addresses
Primary practice location
674 Boulevard de France,
Parris Island, SC 29905
Mailing address
5127 Shoal Line Blvd
Hernando Beach, FL 34607-2715
Phone (352) 596-2604
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200203000424 | FL | Order and Referring Only - Dentist | 4587090048 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 19868 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343001600000",
"number": "1093060410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5127 SHOAL LINE BLVD",
"city": "HERNANDO BEACH",
"state": "FL",
"postal_code": "346072715",
"telephone_number": "352-596-2604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "674 BOULEVARD DE FRANCE,",
"city": "PARRIS ISLAND",
"state": "SC",
"postal_code": "29905",
"telephone_number": "843-228-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESSEL",
"first_name": "NICHOLAS",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-23",
"last_updated": "2012-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 19868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parris Island, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.