Active NPI
Courtney Nowicki, DDS, MS
- Dentist
- Tarpon Springs, FL
National Provider Identifier
1699143115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1417
- Practice address
- 3033 Ridgeline Blvd Ste a
Tarpon Springs, FL 34688-9102 - Phone
- (727) 934-1200
- NPI assigned
- Sep 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1417 | FL | Primary |
Addresses
Primary practice location
3033 Ridgeline Blvd Ste a
Tarpon Springs, FL 34688-9102
Mailing address
3033 Ridgeline Blvd Ste a
Tarpon Springs, FL 34688-9102
Phone (419) 234-8153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 3, 2021 through May 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1417 | FL | MD | Dentist |
| DN21792 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1699143115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3033 RIDGELINE BLVD STE A",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346889102",
"telephone_number": "419-234-8153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 RIDGELINE BLVD STE A",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346889102",
"telephone_number": "727-934-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOWICKI",
"first_name": "COURTNEY",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-15",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "1417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarpon Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.