Active NPI
Nichols Dental Center
- General Practice Dentistry
- Leitchfield, KY
National Provider Identifier
1326217639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6679
- Legal business name
- NICHOLS DENTAL CENTER
- Practice address
- 2471 Elizabethtown Rd
Leitchfield, KY 42754-9119 - Phone
- (270) 259-4008
- Fax
- (270) 259-4009
- NPI assigned
- Feb 21, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jay L Nichols, D.M.D
- Title
- Doctor
- Phone
- (270) 259-4008
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6679 | KY | Primary |
Addresses
Primary practice location
2471 Elizabethtown Rd
Leitchfield, KY 42754-9119
Mailing address
2471 Elizabethtown Rd
Leitchfield, KY 42754-9119
Phone (270) 259-4008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60066792 | Medicaid | KY |
National Provider Directory
National Provider DirectoryLocations
2471 Elizabethtown Rd
Leitchfield, KY 42754
Phone (270) 259-4008
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1203552000000",
"number": "1326217639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2471 ELIZABETHTOWN RD",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "427549119",
"telephone_number": "270-259-4008",
"fax_number": "270-259-4009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2471 ELIZABETHTOWN RD",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "427549119",
"telephone_number": "270-259-4008",
"fax_number": "270-259-4009"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NICHOLS DENTAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-21",
"last_updated": "2008-02-21",
"status": "A",
"authorized_official_last_name": "NICHOLS",
"authorized_official_first_name": "JAY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "DOCTOR",
"authorized_official_telephone_number": "270-259-4008",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.M.D"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "6679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60066792",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leitchfield, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.