Nicholas D Doll, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

019.029801 Issued in IL

Practice address

1400 E Carroll St
Suite B
Macomb, IL 61455-1801

Phone

(309) 421-3163

NPI assigned

Jun 19, 2014

Last updated

Jun 19, 2014By the provider in NPPES

Sex

Male

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 IL

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

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1306250147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E CARROLL ST",
            "address_2": "SUITE B",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614551801",
            "telephone_number": "309-421-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E CARROLL ST",
            "address_2": "SUITE B",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614551801",
            "telephone_number": "309-421-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLL",
        "first_name": "NICHOLAS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denman Services, Inc (Macomb Medical Equipment & Supply)
• Marilyn Kay Derry
• Rebecca E Derry, MSED, NCC, LCPC
• Jon Karl Dively, DDS
• Diana Brook Dobier, PSYD LCP
• Kaylen Paige Dorich, LCSW
• Dr Eric Botts & Associates LLC
• Kristen Jean Draughan, LCSW
• Madhu Dukkipati, M.D.
• Nicole Christina Dziuba, PHARMD

• Dentist in Macomb, IL
• Providers in Macomb, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.