NPIMap

Organization Active NPI

Steven L. Nicholson, DDS, PC

  • General Practice Dentistry
  • Jasper, IN
National Provider Identifier
1174860951
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7641 Issued in IN
Legal business name
STEVEN L. NICHOLSON, DDS, PC
Practice address
1444 Executive Blvd
Jasper, IN 47546-9300
Phone
(812) 481-2121
Fax
(812) 481-2215
NPI assigned
Jan 14, 2013
Last updated
Jan 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Dr. Steven L Nicholson, DDS
Title
President
Phone
(812) 481-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7641 IN Primary

Addresses

Primary practice location

1444 Executive Blvd
Jasper, IN 47546-9300

Mailing address

PO Box 1014
Jasper, IN 47547-1014

National Provider Directory

National Provider Directory

Locations

1444 Executive Blvd
Jasper, IN 47546
Phone (812) 481-2121

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1174860951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475471014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 EXECUTIVE BLVD",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469300",
            "telephone_number": "812-481-2121",
            "fax_number": "812-481-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN L. NICHOLSON, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-481-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "7641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.