Provider Demographics
NPI:1275195356
Name:KAISER, NICHOLAS ARTHUR (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ARTHUR
Last Name:KAISER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 DIVISION ST APT 804
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5090
Mailing Address - Country:US
Mailing Address - Phone:502-235-4934
Mailing Address - Fax:
Practice Address - Street 1:1060 CROSSINGS CIRCLE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174
Practice Address - Country:US
Practice Address - Phone:931-499-3148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN110611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice