Provider Demographics
NPI:1013495985
Name:NED L. NIX, DDS, INC
Entity Type:Organization
Organization Name:NED L. NIX, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESICENT
Authorized Official - Prefix:
Authorized Official - First Name:NED
Authorized Official - Middle Name:
Authorized Official - Last Name:NIX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-225-5000
Mailing Address - Street 1:704 BLOSSOM HILL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-5403
Mailing Address - Country:US
Mailing Address - Phone:408-225-5000
Mailing Address - Fax:
Practice Address - Street 1:704 BLOSSOM HILL RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-5403
Practice Address - Country:US
Practice Address - Phone:408-225-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty