Provider Demographics
NPI:1578600375
Name:NICHOLSON, CHRISTINE P (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:P
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:P
Other - Last Name:KINDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CHRISTINE P KINDLER
Mailing Address - Street 1:1531 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1043
Mailing Address - Country:US
Mailing Address - Phone:614-351-0555
Mailing Address - Fax:
Practice Address - Street 1:1219 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-6001
Practice Address - Country:US
Practice Address - Phone:614-839-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH215311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2396849Medicaid