Gary S. Nickerson in Orland Park - Pediatric Dentistry
Gary S. Nickerson - NPI 1386669257
Gary S. Nickerson is a Pediatric Dentistry in Orland Park, Illinois. Gary S. Nickerson practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Gary S. Nickerson is 1386669257. The last update date is 2007-07-09.
Gary S. Nickerson's current location address is 8330 W 145th Pl, Orland Park, Illinois. You can contact this provider via phone number 7083498677. The mailing address for Gary S. Nickerson is 8330 W 145th Pl, Orland Park, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary S. Nickerson |
|---|---|
| Address | 8330 W 145th Pl, Orland Park, Illinois |
| Phone Number | 7083498677 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1386669257 |
|---|---|
| Provider Enumeration Date | 2006-07-13 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 8330 W 145th Pl |
|---|---|
| City | Orland Park |
| State | Illinois (IL) |
| Post Code | 604622867 |
| Phone Number | 7083498677 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 12009939A |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 130765 | IN | UNITED CONCORDIA | |
| 755187 | IN | UNITED CONCORDIA |
Post Comment/ Review Below
What is the unique identifier code issued to Gary S. Nickerson by the Centers for Medicare & Medicaid Services?
The Gary S. Nickerson has been assigned the NPI (National Provider Identifier) 1386669257. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Gary S. Nickerson?
The Gary S. Nickerson is situated at 8330 W 145Th Pl, in the city of Orland Park, state of IL, with the zip code 604622867.
What is Gary S. Nickerson's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Gary S. Nickerson is Pediatric Dentistry, and the corresponding taxonomy classification code for this specialized field is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services issue the 1386669257 to Gary S. Nickerson?
The Gary S. Nickerson received its 1386669257 assignment from the Centers for Medicare & Medicaid Services on 2006-07-13.
When was the information pertaining to Gary S. Nickerson most recently updated or revised?
The details related to Gary S. Nickerson, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-09.