William Grant Nicklas, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DS20762L Issued in PA

Practice address

301 Oxford Valley Rd
301A
Yardley, PA 19067-7706

Phone

(215) 493-8485

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

Yes

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 PA

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

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1982640165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "301A",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190677706",
            "telephone_number": "215-493-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "301A",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190677706",
            "telephone_number": "215-493-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKLAS",
        "first_name": "WILLIAM",
        "middle_name": "GRANT",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "DS20762L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne F Needleman, LIC PSYCHOLOGIST PA
• Makenzie Leigh Nehlig
• Neil S Silber MD
• Richard Nelson, RPH
• Abigail Nester
• Jennifer A Niemeyer, M.S. CCC-SLP
• Craig Edward Nixon, D.M.D.,M.S.
• Vincent M Nola, PSY.D.
• Michael Nolte I, MSN, RN
• Normandy Optical, LLC

• Oral & Maxillofacial Surgery (D.M.D.) in Yardley, PA
• Providers in Yardley, PA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.