Provider Demographics
NPI:1407578578
Name:DIKIC, NIKOLA (DDS)
Entity Type:Individual
Prefix:
First Name:NIKOLA
Middle Name:
Last Name:DIKIC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1630
Mailing Address - Country:US
Mailing Address - Phone:330-696-9535
Mailing Address - Fax:
Practice Address - Street 1:8301 W RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5524
Practice Address - Country:US
Practice Address - Phone:216-642-6291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026982122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist