Nicholas D Allan, D.M.D

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

30349 Issued in TX

Practice address

2831 E Southern Ave
#215
Mesa, AZ 85204-5500

Phone

(618) 972-8464

NPI assigned

Apr 11, 2011

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 TX

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

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1609166644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 FAR WEST BLVD",
            "address_2": "330",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313080",
            "telephone_number": "512-343-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 E SOUTHERN AVE",
            "address_2": "#215",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045500",
            "telephone_number": "618-972-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLAN",
        "first_name": "NICHOLAS",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-11",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "30349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• All in One Health Center LLC
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• All Sports Foundation, Inc
• All Sports Foundation, Inc
• Mistelle Allan, NP
• Veronica Allard, LPC
• Allegiant Healthcare Al, LLC
• Allegiant Healthcare East, LLC
• Allegiant Healthcare West, LLC
• Allen Family Medicine PLLC

• Periodontics in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.