Paul Russell a Nicotra Sr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

135 W Johnson St
Suite 3
Palatine, IL 60067

Phone

(847) 358-4700

Fax

(847) 358-8625

NPI assigned

Sep 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

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.

• Dr Paul Russell a Nicotra DDS LTD

  • General Practice Dentistry
  • Palatine, IL
  • NPI 1578752044
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1831385004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W JOHNSON ST",
            "address_2": "SUITE 3",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "60067",
            "telephone_number": "847-358-4700",
            "fax_number": "847-358-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W JOHNSON ST",
            "address_2": "SUITE 3",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "60067",
            "telephone_number": "847-358-4700",
            "fax_number": "847-358-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOTRA",
        "first_name": "PAUL",
        "middle_name": "RUSSELL A",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tia Ngo, OT
• Phuong Nguyen
• Lauren Nicholson, COTA/L
• Nicole Miller Inc
• Dara Nicole
• Mark J. Niekrasz, D.D.S.
• Greta Nielsen, LCPC
• Carli Nissen
• Carol Lynn Nolan
• Valerie Nootbaar, LPC

• General Practice Dentistry in Palatine, IL
• Providers in Palatine, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.