Nicholas Dulock

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

04831 Issued in NH

Practice address

31 Old Etna Rd Ste N1
Lebanon, NH 03766-1933

Phone

(978) 888-7403

NPI assigned

Jun 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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

State licenses

Practice roles

Locations

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.

• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  Medicare reassignment NPD
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Medicare reassignment NPD
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237
  NPD
• Mary Hitchcock Memorial Hospital

  • Psychiatric Hospital
  • Hampstead, NH
  • NPI 1699584219
  NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1962196949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CEDARWOOD LN UNIT 408",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037664447",
            "telephone_number": "978-888-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OLD ETNA RD STE N1",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661933",
            "telephone_number": "978-888-7403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DULOCK",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "04831",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "04831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindy Dube, APRN
• Sarah A Duffley, MSW
• Shanna Duffy, PT, DPT
• Laura E Dufort, OTR/L
• Eileen Moira Duggan, MD, MPH
• Lauren Elizabeth Dumas, FNP-BC
• Courtney Ann Dumont
• Mieke Marie Dumont, MB,BCH BAO
• Roland Dumont
• Nancy Marie Dunbar, MD

• General Practice Dentistry in Lebanon, NH
• Providers in Lebanon, NH by specialty
• General Practice Dentistry in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.