Cornelius a. Nicholson

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

6379 Issued in WA

Legal business name

CORNELIUS A. NICHOLSON

Practice address

2815 S McClellan St
Seattle, WA 98144-5407

Phone

(206) 722-5000

Fax

(206) 721-1428

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Cornelius A Nicholson, DDSNPI 1528131901

Title

President/ Owner

Phone

(206) 722-5000

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cornelius Adolphus Nicholson, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Seattle, WA
  • NPI 1528131901
  NPD (past) Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1528153343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S MCCLELLAN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981445407",
            "telephone_number": "206-722-5000",
            "fax_number": "206-721-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S MCCLELLAN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981445407",
            "telephone_number": "206-722-5000",
            "fax_number": "206-721-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELIUS A. NICHOLSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "CORNELIUS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "206-722-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "6379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "5055728",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5055728",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROV# UNITED CORNCORDIA",
            "identifier": "000830508",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Cormier
• Kevin Cormier
• Ayumi I Corn, MD
• Anda Maria Cornea, M.D., PH.D.
• Paul Cornelison, PHARMD
• Zack Tyler Corneliusen, DC
• Catherine J. Cornell, A.R.N.P.
• Hayley Jolaine Cornell
• Heather Nicole Cornell, MS, OTR/L, CLT
• Geoffrey Winston Corner, PHD

• Dental Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.