Provider Demographics
NPI:1881925550
Name:NIXON, DASONJ O (DDS)
Entity type:Individual
Prefix:DR
First Name:DASONJ
Middle Name:O
Last Name:NIXON
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 1:101 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5108
Mailing Address - Country:US
Mailing Address - Phone:717-450-7015
Mailing Address - Fax:717-273-2817
Practice Address - Street 1:101 S 9TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5108
Practice Address - Country:US
Practice Address - Phone:717-450-7015
Practice Address - Fax:717-273-2817
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10172122300000X
PADS039510122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist