Howard M Nichols, D.D.S.
Individual provider Active NPI General Practice Dentistry · Ignacio, CO
NPI 1124168158 · NPPES record last updated Jul 25, 2007
Key facts
- NPI
- 1124168158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 05519 (IA)
- Practice address
- 123 Weeminuche Avenue
Ignacio, CO 81137 - Phone
- (970) 563-4581
- Fax
- (970) 563-0206
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 9474 | CO | MD | Dentist |
| 05519 | IA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 05519 | IA | Yes |
| Dentist | 122300000X | 9474 | CO |
Addresses
Primary practice location
123 Weeminuche Avenue
Ignacio, CO 81137
Mailing address
555 Rivergate Ste B2-143
Durango, CO 81301-7481
Phone (970) 382-9164
Other providers in Ignacio, CO
- Keri McDuffie
- Dixie Ann Melton
- Connie Meyer
- Ena Marie Millich
- James Trevor Millward
- Carrie Nicol
- Notramic LLC
- Hannah Marie Nusz
- Lars Olson
- Danielle Ortega
All providers in Ignacio, CO · General Practice Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2007. 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.