Provider Demographics
NPI:1114805215
Name:NICOLINI PEDIATRICS PLLC
Entity type:Organization
Organization Name:NICOLINI PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-898-1919
Mailing Address - Street 1:4310 GEORGE WASHINGTON MEM HWY STE C
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2880
Mailing Address - Country:US
Mailing Address - Phone:757-898-1919
Mailing Address - Fax:
Practice Address - Street 1:4310 GEORGE WASHINGTON MEM HWY STE C
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2880
Practice Address - Country:US
Practice Address - Phone:757-898-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAMOURI COSMETIC AND FAMILY DENISTRY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty