Provider Demographics
NPI:1477237485
Name:MEYER, NIKITA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NIKITA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10050 LONE TREE LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-6537
Mailing Address - Country:US
Mailing Address - Phone:407-575-8945
Mailing Address - Fax:
Practice Address - Street 1:1111 PERSON ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4146
Practice Address - Country:US
Practice Address - Phone:407-870-7404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN280911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice