Nicole Marie Deshon Nelson, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0401414265 Issued in VA

Practice address

25 Cleveland Ave Ste E
Martinsville, VA 24112-2935

Phone

(276) 638-8888

NPI assigned

Mar 29, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Nicole Marie Deshon Former name

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1699353169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CLEVELAND AVE STE E",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122935",
            "telephone_number": "276-638-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CLEVELAND AVE STE E",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122935",
            "telephone_number": "276-638-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHON NELSON",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401414265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DESHON",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dana Trent Dehart, LPC
• Tiffany Nicole Deloatch Bailey, DPT, OCS
• Linda B Delport, LPT
• Denture Express of Martinsville, LLC
• Dependable Home Healthcare, LLC
• Terrence Joseph Despot, PTA
• Craig B Dietrich, D.M.D.
• Deshunta Dillard
• Tanell Dillard
• Wyvette Dillard

• Orthodontics and Dentofacial Orthopedics Dentistry in Martinsville, VA
• Providers in Martinsville, VA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.