Provider Demographics
NPI:1083055701
Name:CULPEPPER, NICHOLAS MCRAE (DDS)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:MCRAE
Last Name:CULPEPPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 W PINNACLE POINTE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8133
Mailing Address - Country:US
Mailing Address - Phone:479-936-8877
Mailing Address - Fax:
Practice Address - Street 1:5501 W PINNACLE POINTE DR STE 1
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8133
Practice Address - Country:US
Practice Address - Phone:479-936-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR39541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice