Spencer Chong Nicholson, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35977 Issued in TX

Practice address

808 NE Mall Blvd
Hurst, TX 76053-4653

Phone

(817) 595-9675

NPI assigned

Jun 9, 2006

Last updated

Feb 20, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smile Care Northeast, PLLC

  dba Ideal Dental Hurst

  • Dentist
  • Hurst, TX
  • NPI 1235366519

  General Practice

  NPD
• Procare Dental Group, P.C.

  dba Central DuPage Dental Group

  • Dentist
  • Wheaton, IL
  • NPI 1215094883
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1215978655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 DELAINA DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750220994",
            "telephone_number": "630-433-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 NE MALL BLVD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760534653",
            "telephone_number": "817-595-9675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Blanchard Cir",
            "address_2": "Suite LLG",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601871037",
            "country_code": "US",
            "telephone_number": "630-681-0108",
            "fax_number": "630-681-0169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SPENCER",
        "middle_name": "CHONG",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025594",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kami K Nguyen, OD
• Lan Nguyen, PHARM D
• Monique Nguyen, M.A.
• Tho Quoc Nguyen, M.D.
• Kristen Belcher Nichols, RD
• Vannessa Jenee Nicholson, LPC
• Bobby Gordon Nieman, L. P .C.
• Luis Nieves, M.D.
• Nightingale of Houston, Inc (Nightingale Home Healthcare of North Texas)
• Nocona Hospital District (Oakmont Guest Care Center LLC)

• General Practice Dentistry in Hurst, TX
• Providers in Hurst, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.