Provider Demographics
NPI:1629086558
Name:NICHOLS, MARIA FERRER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:FERRER
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:F
Other - Last Name:NICHOLS FENNEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5100 WISCONSIN AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:202-363-1158
Mailing Address - Fax:202-363-7052
Practice Address - Street 1:5100 WISCONSIN AVE
Practice Address - Street 2:STE 310
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016
Practice Address - Country:US
Practice Address - Phone:202-363-1158
Practice Address - Fax:202-363-7052
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN57051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice