Nicole Ann Nellis, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6618 Issued in OK

Practice address

9314 S Delaware Ave
Tulsa, OK 74137-5600

Phone

(918) 518-6305

NPI assigned

Jun 27, 2014

Sex

Female

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 OK

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

Locations

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.

• Nicole a. Nellis DDS PLLC

  • General Practice Dentistry
  • Tulsa, OK
  • NPI 1265192355
  NPD Authorized official

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1487069530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9314 S DELAWARE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375600",
            "telephone_number": "918-518-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 S DELAWARE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375600",
            "telephone_number": "918-518-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLIS",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Joy Neighbors, RN
• Rachel Ann Neighbors, LCSWUS
• Samme Jo-Lynne Neighbors, M.S., CCC-SLP
• Michele L Neil, DO
• Bradley Miles Nelligan
• Tiffani Marie Nelms, RD/LD
• Catherine Ann Nelson-Thompson, CRNA
• Amy J Nelson, PT, DPT
• Angela Lanele Nelson
• Chase K Nelson, D.O.

• Dentist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.