Provider Demographics
NPI:1215088497
Name:NIKAS, SUZETTE D (DDS)
Entity type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:D
Last Name:NIKAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13190 HAZEL DELL PKWY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8531
Mailing Address - Country:US
Mailing Address - Phone:317-706-1111
Mailing Address - Fax:317-706-8993
Practice Address - Street 1:13190 HAZEL DELL PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8531
Practice Address - Country:US
Practice Address - Phone:317-706-1111
Practice Address - Fax:317-706-8993
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120097411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice