1699170290 NPI number — NICHOLAS E. DANIEL DDS P.C.

Table of content: (NPI 1699170290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699170290 NPI number — NICHOLAS E. DANIEL DDS P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NICHOLAS E. DANIEL DDS P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699170290
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 WEST ST
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-3400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-280-5370
Provider Business Mailing Address Fax Number:
410-280-5372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 WEST ST
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-3400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-280-5370
Provider Business Practice Location Address Fax Number:
410-280-5372
Provider Enumeration Date:
10/27/2014

Additional Information

Authorized Official

Authorized Official Last Name:
DANIEL
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
206-249-3052

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DEN1001048 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1487930640 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com