Provider Demographics
NPI:1124255419
Name:ELLIOTT, NIKKI DEE (RDH)
Entity type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:DEE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 FOREST LN
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5905
Mailing Address - Country:US
Mailing Address - Phone:214-348-5505
Mailing Address - Fax:
Practice Address - Street 1:9550 FOREST LN
Practice Address - Street 2:SUITE 700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5905
Practice Address - Country:US
Practice Address - Phone:214-348-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14926124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist