Epifania V Nicolas
Organization Active NPI Dentist · Blythe, CA
NPI 1962851840 · NPPES record last updated Jun 10, 2016
Key facts
- NPI
- 1962851840
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 40290 (CA)
- Legal business name
- EPIFANIA V NICOLAS
- Practice address
- 301 E Hobsonway
Blythe, CA 92225-1732 - Phone
- (760) 922-2300
- Fax
- (760) 922-2277
- NPI assigned
- Jun 10, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- NICOLAS DENTAL CORPORATION
Authorized official
- Name
- Dr. Epifania Viola Nicolas, D.D.S.
- Title
- President
- Phone
- (661) 845-2246
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Nicolas Dental Corporation
- Part of
- Nicolas Dental Corporation
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 40290 | CA | Yes |
Addresses
Primary practice location
301 E Hobsonway
Blythe, CA 92225-1732
Mailing address
301 E Hobsonway
Blythe, CA 92225-1732
Phone (760) 922-2300
Other names
- Nicolas Dental Corporation
Other providers in Blythe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.