Nicole Diane Palacios Pritchard, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS107013 Issued in CA

Practice address

1845 N Fair Oaks Ave
Pasadena, CA 91103-1620

Phone

(866) 733-5924

NPI assigned

May 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.palaciospritcharddmd.p1@direct.jwch.nextgenshare.com

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.

• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  Medicare reassignment NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1578145660
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1780376947
  NPD (past)

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1265179410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 GLENFELIZ BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391708",
            "telephone_number": "480-231-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 N FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031620",
            "telephone_number": "866-733-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12360 Firestone Blvd",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906504324",
            "country_code": "US",
            "telephone_number": "866-733-5924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALACIOS PRITCHARD",
        "first_name": "NICOLE",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS107013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Painter, M.S., LMFT
• Iris Paiso, DDS
• Jenny H. Pak, PH.D.
• Pala Alta Holding Inc. (Pasa Alta)
• Michelle Palacios Orgas
• Carlos Palacios
• Franco A Palacios
• Ja'Nean Marie Alyce Palacios
• Palafox Psychological Corporation (Meaningful Growth)
• Gwennyth L Palafox, PH.D

• General Practice Dentistry in Pasadena, CA
• Providers in Pasadena, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.