NPIMap

Organization Active NPI

JGN Investments LLC

Doing business as Jeffrey G Nichols DMD PA

  • Dentist
  • Melbourne, FL
National Provider Identifier
1356521876
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15903 Issued in FL
Legal business name
JGN INVESTMENTS LLC
Doing business as
Jeffrey G Nichols DMD PA
Practice address
336 N Babcock St Ste 102
Melbourne, FL 32935-7325
Phone
(321) 255-0199
Fax
(321) 255-7920
NPI assigned
Nov 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Authorized official

Name
Dr. Jeffrey Glen Nichols, DMD
Title
President
Phone
(321) 255-0199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN15903 FL Primary

Addresses

Primary practice location

336 N Babcock St Ste 102
Melbourne, FL 32935-7325

Mailing address

336 N Babcock St Ste 102
Melbourne, FL 32935-7325
Phone (321) 255-0199

Other names 1

  • Jeffrey G Nichols DMD PA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1356521876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 N BABCOCK ST STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357325",
            "telephone_number": "321-255-0199",
            "fax_number": "321-751-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 N BABCOCK ST STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329357325",
            "telephone_number": "321-255-0199",
            "fax_number": "321-255-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JGN INVESTMENTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-255-0199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey G Nichols DMD PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.