Nicole a. Nellis DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NICOLE A. NELLIS DDS PLLC

Practice address

9314 S Delaware Ave
Tulsa, OK 74137-5600

Phone

(918) 518-6305

NPI assigned

Dec 30, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Nellis, DDSNPI 1487069530

Title

Owner

Phone

(918) 728-1449

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Ann Nellis, D.D.S.

  • Dentist
  • Tulsa, OK
  • NPI 1487069530
  NPD Authorized official

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1265192355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9314 S DELAWARE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 S DELAWARE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375600",
            "telephone_number": "918-518-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE A. NELLIS DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "NELLIS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-728-1449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deidra Nickel, LPC
• Jacquelyn Olivia Nickel, RD, MS
• Timothy J Nickel, MD
• Shaun Nickelson
• Krissa Nickles
• Nidra Medical Solutions LLC
• Nidra Sleep Health LLC
• Elise Niehaus
• Caleb Alan Niehues, DO
• Christian Nielsen, D.O.

• General Practice Dentistry in Tulsa, OK
• Providers in Tulsa, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.