Provider Demographics
NPI:1801055884
Name:RICHARD J NYKIEL DDS PC
Entity type:Organization
Organization Name:RICHARD J NYKIEL DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:NYKIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-676-6672
Mailing Address - Street 1:22150 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2271
Mailing Address - Country:US
Mailing Address - Phone:734-676-6672
Mailing Address - Fax:734-676-6646
Practice Address - Street 1:22150 ALLEN RD
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-2271
Practice Address - Country:US
Practice Address - Phone:734-676-6672
Practice Address - Fax:734-676-6646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI119541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty