Individual provider Active NPI

John A Nieskens, DDS

  • Dentist
  • Peterborough, NH
National Provider Identifier
1922294701
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1839 Issued in NH
Practice address
60 Hancock Road
Route 202 North
Peterborough, NH 03458-1107
Phone
(603) 924-3350
Fax
(603) 924-2199
NPI assigned
Sep 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1839 NH Primary

Addresses

Primary practice location

60 Hancock Road
Route 202 North
Peterborough, NH 03458-1107

Mailing address

60 Hancock Road
Route 202 North
Peterborough, NH 03458-1107
Phone (603) 924-3350

Other identifiers 2

IdentifierTypeStateIssuer
1839OtherNHLIC NUMBER
30302680MedicaidNH

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

LicenseStateTypeSpecialty
1839NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nieskens & Yoe DDS 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1922294701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HANCOCK ROAD",
            "address_2": "ROUTE 202 NORTH",
            "city": "PETERBOROUGH",
            "state": "NH",
            "postal_code": "034581107",
            "telephone_number": "603-924-3350",
            "fax_number": "603-924-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HANCOCK ROAD",
            "address_2": "ROUTE 202 NORTH",
            "city": "PETERBOROUGH",
            "state": "NH",
            "postal_code": "034581107",
            "telephone_number": "603-924-3350",
            "fax_number": "603-924-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIESKENS",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "1839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC NUMBER",
            "identifier": "1839",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30302680",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peterborough, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.