Active NPI
Shelly Marie Nichols, RDH
- Dental Hygienist
- Garden Ridge, TX
National Provider Identifier
1376833137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH 17325
- Practice address
- 18945 FM 2252
Suite 115
Garden Ridge, TX 78266-2562 - Phone
- (210) 564-6602
- Fax
- (210) 651-0029
- NPI assigned
- Apr 13, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH 17325 | FL | Primary |
Addresses
Primary practice location
18945 FM 2252
Suite 115
Garden Ridge, TX 78266-2562
Mailing address
18945 FM 2252
Suite 115
Garden Ridge, TX 78266-2562
Phone (210) 564-6602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH 17325 | FL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1376833137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18945 FM 2252",
"address_2": "SUITE 115",
"city": "GARDEN RIDGE",
"state": "TX",
"postal_code": "782662562",
"telephone_number": "210-564-6602",
"fax_number": "210-651-0029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18945 FM 2252",
"address_2": "SUITE 115",
"city": "GARDEN RIDGE",
"state": "TX",
"postal_code": "782662562",
"telephone_number": "210-564-6602",
"fax_number": "210-651-0029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "SHELLY",
"middle_name": "MARIE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-13",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "FL",
"license": "DH 17325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Ridge, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.