Active NPI
David William Nicholls, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- Mission Viejo, CA
National Provider Identifier
1215940952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 33505
- Practice address
- 26302 La Paz Rd
Suite 102
Mission Viejo, CA 92691-5313 - Phone
- (949) 586-7000
- Fax
- (949) 586-0158
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 33505 | CA | Primary |
Addresses
Primary practice location
26302 La Paz Rd
Suite 102
Mission Viejo, CA 92691-5313
Mailing address
26302 La Paz Rd
Suite 102
Mission Viejo, CA 92691-5313
Phone (949) 586-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Anesthesia Medical Associates Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Mission Viejo, CA
- NPI 1497796320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215940952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26302 LA PAZ RD",
"address_2": "SUITE 102",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926915313",
"telephone_number": "949-586-7000",
"fax_number": "949-586-0158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26302 LA PAZ RD",
"address_2": "SUITE 102",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926915313",
"telephone_number": "949-586-7000",
"fax_number": "949-586-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLLS",
"first_name": "DAVID",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "33505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.