Provider Demographics
NPI:1316728363
Name:NICHOLAS S. ISING DMD, MS, PLLC
Entity type:Organization
Organization Name:NICHOLAS S. ISING DMD, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ISING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:270-769-2186
Mailing Address - Street 1:1102 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2750
Mailing Address - Country:US
Mailing Address - Phone:270-769-2186
Mailing Address - Fax:
Practice Address - Street 1:1102 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2750
Practice Address - Country:US
Practice Address - Phone:270-769-2186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty