Active NPI
Justin M. Nichols, DDS
- Dentist
- Sioux Falls, SD
National Provider Identifier
1881783595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D0522
- Practice address
- 4904 S Minnesota Ave
Sioux Falls, SD 57108-2864 - Phone
- (605) 335-8640
- Fax
- (605) 332-9956
- NPI assigned
- Oct 12, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D0522 | SD | Primary |
Addresses
Primary practice location
4904 S Minnesota Ave
Sioux Falls, SD 57108-2864
Mailing address
4904 S Minnesota Ave
Sioux Falls, SD 57108-2864
Phone (605) 335-8640
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 |
|---|---|---|---|
| D0522 | SD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Motz DDS PC | Dentist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881783595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4904 S MINNESOTA AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571082864",
"telephone_number": "605-335-8640",
"fax_number": "605-332-9956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4904 S MINNESOTA AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571082864",
"telephone_number": "605-335-8640",
"fax_number": "605-332-9956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "JUSTIN",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SD",
"license": "D0522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
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.