Provider Demographics
NPI:1225460181
Name:NAKASHIMA, NICOLE NAHAKU (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:NAHAKU
Last Name:NAKASHIMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355-B FACULTY DRIVE 10DS/SGD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80840-1805
Mailing Address - Country:US
Mailing Address - Phone:808-234-8312
Mailing Address - Fax:
Practice Address - Street 1:2355-B FACULTY DRIVE
Practice Address - Street 2:10 DS/SGD
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-1805
Practice Address - Country:US
Practice Address - Phone:719-333-5192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00201796122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00201796OtherDENTAL LICENSE