Jennie Elizabeth Nichols, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30021813 Issued in OH

Practice address

243 S Broadway St
Medina, OH 44256-2601

Phone

(330) 725-4101

NPI assigned

Jan 9, 2006

Last updated

Jul 13, 2026By the provider in NPPES

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 OH

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629056635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 S BROADWAY ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562601",
            "telephone_number": "330-725-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 S BROADWAY ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562601",
            "telephone_number": "330-725-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JENNIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30021813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarred Newmyer
• Chris NG
• Anh-Steve Huy Nguyen, D.D.S
• Trang Thi Thu Nguyen
• Elaine E Nichols, R.N., C.N.S.
• Jodi Lynn Nichols
• Jovianna Nichols
• Zoeigh David Nichols
• Dawn Elaine Nilsson, PTA
• Kim Vincent Nilsson

• General Practice Dentistry in Medina, OH
• Providers in Medina, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.