Provider Demographics
NPI:1790590248
Name:NICHOLAS A SAMPALIS, DMD, PLLC.
Entity type:Organization
Organization Name:NICHOLAS A SAMPALIS, DMD, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMPALIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:970-872-2299
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:HOTCHKISS
Mailing Address - State:CO
Mailing Address - Zip Code:81419-0007
Mailing Address - Country:US
Mailing Address - Phone:208-929-5059
Mailing Address - Fax:
Practice Address - Street 1:158 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:HOTCHKISS
Practice Address - State:CO
Practice Address - Zip Code:81419-8141
Practice Address - Country:US
Practice Address - Phone:970-872-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental