Active NPI
Jay L Nichols, DMD
- General Practice Dentistry
- Leitchfield, KY
National Provider Identifier
1770566812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- KY6679
- Practice address
- 2471 Elizabethtown Rd
Leitchfield, KY 42754-9119 - Phone
- (270) 259-4008
- Fax
- (270) 259-4009
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | KY6679 | KY | Primary |
Addresses
Primary practice location
2471 Elizabethtown Rd
Leitchfield, KY 42754-9119
Mailing address
2471 Elizabethtown Rd
Leitchfield, KY 42754-9119
Phone (270) 259-4008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY6679 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nichols Dental Center | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770566812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2471 ELIZABETHTOWN RD",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "427549119",
"telephone_number": "270-259-4008",
"fax_number": "270-259-4009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2471 ELIZABETHTOWN RD",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "427549119",
"telephone_number": "270-259-4008",
"fax_number": "270-259-4009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "JAY",
"middle_name": "L",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "KY6679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leitchfield, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.