Active NPI
Brooke D Nichols, RDH, BS
- Dental Hygienist
- Rifle, CO
National Provider Identifier
1780004580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 905457
- Practice address
- 195 W 14TH
Rifle, CO 81650-4700 - Phone
- (970) 625-5200
- NPI assigned
- Apr 18, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 905457 | CO | Primary |
Addresses
Primary practice location
195 W 14TH
Rifle, CO 81650-4700
Mailing address
PO Box 7331
Avon, CO 81620-7331
Phone (612) 799-1691
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 905457 | CO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397779200000",
"number": "1780004580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7331",
"city": "AVON",
"state": "CO",
"postal_code": "816207331",
"telephone_number": "612-799-1691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 W 14TH",
"city": "RIFLE",
"state": "CO",
"postal_code": "816504700",
"telephone_number": "970-625-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "BROOKE",
"middle_name": "D",
"credential": "RDH, BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-18",
"last_updated": "2014-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "905457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rifle, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.