Provider Demographics
NPI:1669537809
Name:NIX, BILLY CHRIS (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:BILLY
Middle Name:CHRIS
Last Name:NIX
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:DR
Other - First Name:B.
Other - Middle Name:CHRIS
Other - Last Name:NIX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:411 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-3635
Mailing Address - Country:US
Mailing Address - Phone:308-345-2273
Mailing Address - Fax:308-345-2750
Practice Address - Street 1:411 W 5TH ST
Practice Address - Street 2:
Practice Address - City:MCCOOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3635
Practice Address - Country:US
Practice Address - Phone:308-345-2273
Practice Address - Fax:308-345-2750
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE46841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE4845OtherBCBS
NE47071874300Medicaid