DR. DALE CHARLES NICKELSEN (NPI# 1265748149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265748149 |
| Entity Type | Individual |
| Full Name | DR. DALE CHARLES NICKELSEN |
| Credential | D.D.S. |
| Practice Address |
860 Summit St Ste 246 Elgin IL 60120-5145 |
| Practice Telephone | 8476951693 |
| Practice Fax Number | 8476959212 |
| Mailing Telephone | 8476951693 |
| Mailing Fax Number | 8476959212 |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
019-012082 | IL | Dental Providers |
| Street Address |
860 SUMMIT ST STE 246 |
| City | ELGIN |
| State | IL |
| Zip Code | 60120-5145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801881156 | Scal Inc | Durable Medical Equipment & Medical Supplies | 860 Summit St, Elgin, IL 60120-5145 | 2005-09-13 |
| 1114296712 | Smiles of Elgin P.c | Dentist | 860 Summit St, Suite 134, Elgin, IL 60120-5145 | 2011-12-28 |
| 1902051121 | Meghan Kathleen Whelan | Physician Assistant | 860 Summit St, Suite 123, Elgin, IL 60120 | 2008-12-02 |
| 1447421615 | Parin K Desai Dds, PC | Dentist | 860 Summit St, Suite 111, Elgin, IL 60120-5145 | 2008-03-17 |
| 1952583783 | V Susarla Mdsc | Family Medicine | 860 Summit St, Suite 123, Elgin, IL 60120-5145 | 2007-12-04 |
| 1457483547 | Aleksandra M Gwozdz | Dentist | 860 Summit St, #134, Elgin, IL 60120 | 2007-03-12 |
| 1952454878 | Pediatric Dentistry Ltd | Clinic/Center | 860 Summit St, Suite 246, Elgin, IL 60120-5145 | 2007-01-22 |
| 1528132933 | Thomas Pointner | Dentist | 860 Summit St, Suite 153, Elgin, IL 60120-5145 | 2006-11-17 |
| 1518976323 | Savitha Susarla | Family Medicine | 860 Summit St, Ste 123, Elgin, IL 60120-5145 | 2006-08-08 |
| 1922014315 | Viswanatham Susarla | Internal Medicine | 860 Summit St, Ste 123, Elgin, IL 60120-5145 | 2006-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003391749 | Kids Above All | Clinic/Center | United Methodist Church, 651 Lillie Street, Elgin, IL 60120 | 2018-09-28 |
| 1215483979 | Kelly Fetherling | Social Worker | 6912 S Main St., Elgin, IL 60120 | 2016-08-31 |
| 1164870457 | Peter Norton | Pharmacist | 1038 Summit Street, Elgin, IL 60120 | 2016-05-27 |
| 1417316373 | Beverly Brewster | Counselor | 675 Varsity Dr., Elgin, IL 60120 | 2016-02-19 |
| 1407194780 | Well Baby Care PC | Pediatrics | 1185-87 Dundee Avenue, Suite A-2, Elgin, IL 60120 | 2013-01-22 |
| 1740533546 | Vna Health Care | Clinic/Center | 801 Villa Street, Elgin, IL 60120 | 2012-10-18 |
| 1457638934 | Sharon Rose Nemenzo Araneta | Physical Therapist | 795 Summit St, Elgin, IL 60120 | 2011-11-10 |
| 1770866451 | Claudette M Vanhessen | Pharmacist | 815 Summit Street, Elgin, IL 60120 | 2011-09-20 |
| 1083993430 | Monica J. Fudala | Family Medicine | 820 Summit St # B4, Elgin, IL 60120 | 2011-08-16 |
| 1144517830 | Complete Care Medical Center, S.c | Family Medicine | 373 Summit St Ste 100, Elgin, IL 60120 | 2011-07-01 |
| Find all providers in zip 60120 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235587700 | Elgin Pediatric Dental Pllc | Dentist | 250 W Us Highway 290 # A, Elgin, TX 78621-3206 | 2016-05-25 |
| 1497185185 | Harry O Channon Sr. | Dentist | 8n515 Shady Ln, Elgin, IL 60124-8557 | 2013-11-18 |
| 1265717276 | Pediatric and Family Dental PC | Dentist | 2050 Larkin Ave, Suite 100, Elgin, IL 60123-4405 | 2011-10-21 |
| 1235433012 | Scott D. Goldman, Dds, PC | Dentist | 2050 Larkin Ave, Suite 100, Elgin, IL 60123-4405 | 2011-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1073125746 | Jessica Mattern Dds, Pllc | Dentist | 326 W Burlington Ave, La Grange, IL 60525-2363 | 2020-08-23 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1710450754 | Drs Selberg & Rice Pllc | Dentist | 4945 Stone Falls Ctr Ste B, O Fallon, IL 62269-7801 | 2019-01-02 |
| 1821583634 | Dentalgenix | Dentist | 113 E Schaumburg Rd, Schaumburg, IL 60194-3518 | 2018-06-25 |
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1942740006 | Dhwani M. Joshi | Dentist | 195 S Rand Rd Ste 110, Lake Zurich, IL 60047-2205 | 2017-03-08 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1669839593 | Algonquin Kids Dentistry, Inc | Dentist | 4097 W Algonquin Rd, Algonquin, IL 60102-9401 | 2016-01-22 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.