Provider Demographics
NPI:1215904545
Name:KUGIA, NICHOLAS (DDS)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:KUGIA
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 1:1425 N MCLEAN BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5723
Mailing Address - Country:US
Mailing Address - Phone:847-468-0700
Mailing Address - Fax:847-741-7768
Practice Address - Street 1:1425 N MCLEAN BLVD
Practice Address - Street 2:SUITE 800
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5723
Practice Address - Country:US
Practice Address - Phone:847-468-0700
Practice Address - Fax:847-741-7768
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0222671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice