Paul Robert Niesen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11526 Issued in MD

Practice address

7 Russell Ave
Suite a
Gaithersburg, MD 20877-2968

Phone

(301) 926-6996

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

Yes

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 MD

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629293162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 RUSSELL AVE",
            "address_2": "SUITE A",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772968",
            "telephone_number": "301-926-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 RUSSELL AVE",
            "address_2": "SUITE A",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772968",
            "telephone_number": "301-926-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIESEN",
        "first_name": "PAUL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yan Ni, PSYD
• Homa Julie Niazi, O.D.
• Karalynn Nichols
• Joseph James Nicol, M.A.
• Nicole Asbahr, M.Ac, L.Ac, Licensed Acupuncturist
• Sonia Beatriz Nieves
• Ashley Niles
• Cheryl J Nilsen, PT
• Kathleen Elizabeth Nimtz
• Nelson T Niu, M.D.

• General Practice Dentistry in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.