Sean D Nickens, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS035854 Issued in PA

Practice address

620 Paxton PL
Ste 104
Lititz, PA 17543-8279

Phone

(717) 569-7645

Fax

(717) 569-7650

NPI assigned

May 22, 2007

Last updated

Apr 26, 2009By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240704000000",
    "number": "1659580611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PAXTON PL",
            "address_2": "STE 104",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175438279",
            "telephone_number": "717-569-7645",
            "fax_number": "717-569-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PAXTON PL",
            "address_2": "STE 104",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175438279",
            "telephone_number": "717-569-7645",
            "fax_number": "717-569-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKENS",
        "first_name": "SEAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Isaac Eugene Nivar, DO
• Pamela Lynn Noden, M.S., LPC, CAC
• Northern Lancaster County Medical Group (Grace Pediatrics)
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• Now I Can Foundation Northeast

• General Practice Dentistry in Lititz, PA
• Providers in Lititz, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2009; 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.