Jerry Dallas Nichols, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1907 Issued in AR

Practice address

3354 Old Airport Rd
Pearcy, AR 71964-9445

Phone

(501) 767-0011

Fax

(501) 767-5686

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• J. Michael Plyler, DDS, PA

  dba Pearcy Family Dental

  • Dentist
  • Pearcy, AR
  • NPI 1083082937
  NPD (past)
• Stan Ware, DDS PA

  • Dentist
  • Pearcy, AR
  • NPI 1295007540
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285642876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 OLD AIRPORT RD",
            "city": "PEARCY",
            "state": "AR",
            "postal_code": "719649445",
            "telephone_number": "501-767-0011",
            "fax_number": "501-767-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 OLD AIRPORT RD",
            "city": "PEARCY",
            "state": "AR",
            "postal_code": "719649445",
            "telephone_number": "501-767-0011",
            "fax_number": "501-767-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JERRY",
        "middle_name": "DALLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "1907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "58471",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA NUMBER",
            "identifier": "841975",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Hamilton School District
• Julie Lynn Logan, D.C.
• Debra D Loyd, MSE, CCC/SLP
• Natalie S. Manatt, APRN
• Susan Ann Murch, CCC/SLP
• Restore Healing Center LLC
• Jessica Roper, APRN
• Angy Rose, PT
• Kristin Elizabeth Shults, MS, CCC-SLP
• Stan Ware, DDS PA

• General Practice Dentistry in Pearcy, AR
• Providers in Pearcy, AR by specialty
• General Practice Dentistry in Arkansas

• 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.

Verify at the official NPI Registry.