Active NPI
Jeffrey Todd Nichols, D.M.D
- Dentist
- Columbus, MS
National Provider Identifier
1245348960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5389 C
- Practice address
- 2401 5TH St N
Suite 2
Columbus, MS 39705-2005 - Phone
- (662) 713-1111
- Fax
- (662) 713-1113
- NPI assigned
- Aug 25, 2006
- Last updated
- Sep 11, 2025
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2882-95 | MS | |
| Dentist | 122300000X | 5389 C | AL | Primary |
| Periodontics | 1223P0300X | PER-323-98 | MS | |
| Periodontics | 1223P0300X | 5389 C | AL |
Addresses
Primary practice location
2401 5TH St N
Suite 2
Columbus, MS 39705-2005
Mailing address
1709 Chickasaw Dr
Columbus, MS 39705-1430
Phone (662) 241-4952
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2882-95 | MS | MD | Dentist |
| 5389 C | AL | MD | Periodontist |
| PER-323-98 | MS | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nichols Periodontics LLC | Periodontics | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Periodontics
- Columbus, MS
- NPI 1134341407
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1245348960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1709 CHICKASAW DR",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "397051430",
"telephone_number": "662-241-4952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 5TH ST N",
"address_2": "SUITE 2",
"city": "COLUMBUS",
"state": "MS",
"postal_code": "397052005",
"telephone_number": "662-713-1111",
"fax_number": "662-713-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "JEFFREY",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "2882-95",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "5389 C",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MS",
"license": "PER-323-98",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "AL",
"license": "5389 C",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.