Thomas Richard Nankivell, DDS
Individual provider Active NPI Dentist · Millerstown, PA
NPI 1720156763 · NPPES record last updated Sep 9, 2015
Key facts
- NPI
- 1720156763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS018699L (PA)
- Practice address
- 701 E Sunbury Street
Millerstown, PA 17062 - Phone
- (717) 589-3990
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS018699L | PA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS018699L | PA | Yes |
Addresses
Primary practice location
701 E Sunbury Street
Millerstown, PA 17062
Mailing address
703 Poplar Street
Millerstown, PA 17062
Phone (717) 589-3405
Other providers in Millerstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.