Provider Demographics
NPI:1114304524
Name:NORVELL, NICHOLAS G (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:G
Last Name:NORVELL
Suffix:
Gender:
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1984 PROVIDENCE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-4459
Mailing Address - Country:US
Mailing Address - Phone:615-257-7723
Mailing Address - Fax:615-257-7729
Practice Address - Street 1:1984 PROVIDENCE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4459
Practice Address - Country:US
Practice Address - Phone:615-257-7723
Practice Address - Fax:615-257-7729
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN99301223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty