Provider Demographics
NPI:1336707728
Name:CUCCHI, NICOLE MADELINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MADELINE
Last Name:CUCCHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 FALLS VALLEY DR STE 107
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2496
Mailing Address - Country:US
Mailing Address - Phone:919-327-1770
Mailing Address - Fax:
Practice Address - Street 1:431 KEISLER DR STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7064
Practice Address - Country:US
Practice Address - Phone:919-859-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice