Robert Leon Nicola, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901016827 Issued in MI

Practice address

1522 W Centre Avenue
Portage, MI 49024

Phone

(269) 327-6765

Fax

(269) 327-1138

NPI assigned

Feb 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• General Dentistry PC

  • Dentist
  • Portage, MI
  • NPI 1639204852
  NPD (past) Authorized official

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912046319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 W CENTRE AVENUE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49024",
            "telephone_number": "269-327-6765",
            "fax_number": "269-327-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 W CENTRE AVENUE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49024",
            "telephone_number": "269-327-6765",
            "fax_number": "269-327-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLA",
        "first_name": "ROBERT",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Newhouse
• Nicholas Newman, LLMSW
• Charmeka S Newton, PH.D
• Nautika Newton
• Next Step Physical Therapy & Sports Performance
• Ernest Noel
• Joseph Neil Norcross, M.A., BCBA
• Norr Optical Inc
• Larry Lee Norris, D.C.
• Mary C Norris, P.T.A

• Dentist in Portage, MI
• Providers in Portage, MI by specialty
• Dentist in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.