Provider Demographics
NPI:1639644321
Name:NICOLE L BELLINGHAM, DDS, PLLC
Entity Type:Organization
Organization Name:NICOLE L BELLINGHAM, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BELLINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-292-3820
Mailing Address - Street 1:800 W ELDORADO PKWY STE 124
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5134
Mailing Address - Country:US
Mailing Address - Phone:972-292-3820
Mailing Address - Fax:972-292-3802
Practice Address - Street 1:800 W ELDORADO PKWY STE 124
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5134
Practice Address - Country:US
Practice Address - Phone:972-292-3820
Practice Address - Fax:972-292-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental