Dr. Patricia Nicklas

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4626 Issued in SC

Legal business name

DR. PATRICIA NICKLAS

Doing business as

Nicklas Dental

Practice address

9565 Highway 78
Unit 600B
Ladson, SC 29456-4118

Phone

(843) 412-4036

NPI assigned

Aug 15, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Patricia Nicklas, DDS

Title

Member/Dentist

Phone

(843) 412-4036

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Nicklas Dental Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Edward Crane III, DMD

  • Dentist
  • Ladson, SC
  • NPI 1760968606
  NPD (past)
• Jennie O Reardon, DMD

  • General Practice Dentistry
  • Ladson, SC
  • NPI 1568895357
  NPD (past)

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1558794396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9565 HIGHWAY 78",
            "address_2": "UNIT 600B",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564118",
            "telephone_number": "843-412-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9565 HIGHWAY 78",
            "address_2": "UNIT 600B",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564118",
            "telephone_number": "843-412-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PATRICIA NICKLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "NICKLAS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "MEMBER/DENTIST",
        "authorized_official_telephone_number": "843-412-4036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023230414",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4626",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicklas Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Dillard
• Heather Michelle Dixon, OTR/L
• Tess E Doty, OTR/L
• Dr. David W. Bang, P.C.
• Dr. David W. Bang, P.C.
• Cenyetta Edell Drayton
• Lauren Dugan, MCD CCC-SLP
• E&RR Services LLC
• Amy Nicole Elgin, MSOL, OTR/L, BCP
• Rachel Dawn Ellyn, MD

• General Practice Dentistry in Ladson, SC
• Providers in Ladson, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.