Jonathan Louis Nicozisis, DMD, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22DI02077500 Issued in NJ

Practice address

601 Ewing St. B-12
Princeton, NJ 08540

Phone

(609) 924-3271

Fax

(609) 924-7098

NPI assigned

Nov 22, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Louis J Russo Jr Jonathan L Nicozisis DMD Ms PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Princeton, NJ
  • NPI 1942425137
  NPD (past) Authorized official

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1356771687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 EWING ST. B-12",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "609-924-3271",
            "fax_number": "609-924-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EWING ST. B-12",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08540",
            "telephone_number": "609-924-3271",
            "fax_number": "609-924-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOZISIS",
        "first_name": "JONATHAN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02077500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.