Active NPI
Craig Nikolaus, D.D.S.
- Dentist
- Prescott, AZ
National Provider Identifier
1831557230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11411
- Practice address
- 1583 Prescott View Cir
Prescott, AZ 86301-1556 - Phone
- (480) 717-2847
- NPI assigned
- Feb 1, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D0009395 | AZ | |
| Dentist | 122300000X | 11411 | TN | Primary |
Addresses
Primary practice location
1583 Prescott View Cir
Prescott, AZ 86301-1556
Mailing address
1583 Prescott View Cir
Prescott, AZ 86301-1556
Phone (480) 717-2847
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0009395 | AZ | MD | Dentist |
| 11411 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1831557230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1583 PRESCOTT VIEW CIR",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011556",
"telephone_number": "480-717-2847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1583 PRESCOTT VIEW CIR",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011556",
"telephone_number": "480-717-2847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIKOLAUS",
"first_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-01",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D0009395",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "11411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.