Organization Active NPI

Dr Richard Nichols Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bozeman, MT
National Provider Identifier
1376730853
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1304 Issued in MT
Legal business name
DR RICHARD NICHOLS ORTHODONTICS
Practice address
208 N 11TH Ave
Bozeman, MT 59715
Phone
(406) 586-8727
Fax
(406) 586-9382
NPI assigned
Sep 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Miranda Van Dyken, CDA
Title
Office Coordinator
Phone
(406) 586-8727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 1304 MT Primary

Addresses

Primary practice location

208 N 11TH Ave
Bozeman, MT 59715

Mailing address

208 N 11TH Ave
Bozeman, MT 59715
Phone (406) 586-8727

National Provider Directory

National Provider Directory

Locations

208 N 11th Ave
Bozeman, MT 59715
Phone (406) 586-8727

Practitioners & affiliated clinicians

Practitioners 1

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": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1376730853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N 11TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-586-8727",
            "fax_number": "406-586-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N 11TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-586-8727",
            "fax_number": "406-586-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RICHARD NICHOLS ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "VAN DYKEN",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "406-586-8727",
        "authorized_official_credential": "CDA"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MT",
            "license": "1304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.