Berkeley Anthony Nicholls, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN16407 Issued in FL

Practice address

400 Executive Center Drive
Suite 103
West Palm Beach, FL 33401

Phone

(561) 844-7735

Fax

(561) 516-8820

NPI assigned

Oct 14, 2006

Last updated

Dec 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1396835724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EXECUTIVE CENTER DRIVE",
            "address_2": "SUITE 103",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33401",
            "telephone_number": "561-844-7735",
            "fax_number": "561-516-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EXECUTIVE CENTER DRIVE",
            "address_2": "SUITE 103",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33401",
            "telephone_number": "561-844-7735",
            "fax_number": "561-516-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "BERKELEY",
        "middle_name": "ANTHONY",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Nguyen
• Thuong Thuy Truong Nguyen, PSY.D.
• Toan T Nguyen, MD
• Tony Nguyen, PT, DPT
• Truong The Nguyen, PHARMD
• Amy Marie Nichols, PA-C
• Tanya A Nichols, RN CDE
• Cynthia Lubin Nicolas, MA
• Jeanella C Nicolas, ALLIED HEALTH
• Nicole Basile MD PA

• General Practice Dentistry in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.