Nicholas T Nikchevich, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

105583 Issued in CA

Practice address

1100 N State St RM A3C
Los Angeles, CA 90033-5000

Phone

(805) 728-5583

NPI assigned

Feb 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• The Regents of the University of California

  • Plastic Surgery Physician
  • Los Angeles, CA
  • NPI 1164487518
  NPD (past)

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1619509460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 WAVERLY DR APT 906",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392788",
            "telephone_number": "805-728-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N STATE ST RM A3C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335000",
            "telephone_number": "805-728-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKCHEVICH",
        "first_name": "NICHOLAS",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "105583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasreena Nijjar, M.D
• Nijole Glaze ,M.D.
• Atoosa Nikaeen, DDS
• Farsheed Nikbakht, M.D.
• Farid Nikbin, M.D
• Shaya Nikfar
• Carly Nikiforuk, HIGH SCHOOL DIPLOMA
• Hooman Nikizad, MD
• Nikjoo Dental Inc
• Ebi Donavan Nikjoo

• Oral and Maxillofacial Surgery (Dentist) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.