Nicola Villanueva, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1223G0001X Issued in KS

Practice address

2006 N Rock Rd Ste 300
Derby, KS 67037-3857

Phone

(316) 416-6057

NPI assigned

Feb 22, 2025

Last updated

Jul 9, 2025By the provider in NPPES

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

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Derby Modern Dentistry, PA

  dba Derby Modern Dentistry

  • Dentist
  • Derby, KS
  • NPI 1114485794
  NPD (past)

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

{
    "created_epoch": "1740182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1386440006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 N 20TH ST APT 329",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681024309",
            "telephone_number": "312-522-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 N ROCK RD STE 300",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373857",
            "telephone_number": "316-416-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "NICOLA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-22",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "1223G0001X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie B Turner, PT
• Ultimate Views LLC
• Jessica Vail
• Jennifer S Vaughn
• Denise Alejandra Villafranco, LMSW
• Vintage Place of Derby
• Mark N Vinzant, M.D.
• Catherine E. Vitosh, M.D.
• Phuoc Vo, PHARMACIST
• Walgreen Co (Walgreens #06707)

• General Practice Dentistry in Derby, KS
• Providers in Derby, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.