Jeffrey Charles Nickel, DMD MSC PHD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DF0041 Issued in OR

Practice address

2730 S Moody Ave
Portland, OR 97201-5042

Phone

(503) 494-8223

Fax

(503) 494-5777

NPI assigned

Oct 20, 2025

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": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1679440192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S MOODY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015042",
            "telephone_number": "503-494-8223",
            "fax_number": "503-494-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S MOODY AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015042",
            "telephone_number": "503-494-8223",
            "fax_number": "503-494-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKEL",
        "first_name": "JEFFREY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DMD MSC PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OR",
            "license": "DF0041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syrena Nicholson, LMT
• Todd L. Nicholson, M.S.
• Valerie Nicholson
• Nick R. Mellum DMD PC
• Jordan Taylor Nickel-Dubin, MA
• Rachel Nickel, MSW, LICSW
• Jereme Dawn Nickell, OT
• Joshua Phillip Nickelsen
• Jacob Nickerson, LMT
• Joshua Paul Nickerson, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.