Gloria Nichols, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0397601 Issued in NY

Practice address

2041 Penfield Rd
Penfield, NY 14526

Phone

(585) 377-5090

Fax

(585) 377-2873

NPI assigned

Sep 2, 2006

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 NY

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

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.

• Gloria Nichols DDS PC

  • Dental Clinic/Center
  • Penfield, NY
  • NPI 1568058188
  NPD Authorized official

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295837185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 NORTHRUP RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "14526",
            "telephone_number": "585-872-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 PENFIELD RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "14526",
            "telephone_number": "585-377-5090",
            "fax_number": "585-377-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "GLORIA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0397601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Mytych
• Amina N'Gambwa
• Laura Neuderfer Peterson, M.S.
• New Renaissance Dentistry PLLC
• Cheryl A Newman, M.D.
• Anna Nielsen, LMSW
• Nicole L Nolan, DPT
• Marjorie Norlund, LMHC
• Abbey Notter
• Robert S Nyumah, LMFT

• General Practice Dentistry in Penfield, NY
• Providers in Penfield, NY by specialty
• General Practice Dentistry in New York

• 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.
• 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.