Provider Demographics
NPI:1558110676
Name:STONE, NICKOLAS JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:NICKOLAS
Middle Name:JAMES
Last Name:STONE
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 1:2500 S BROADWAY STE 350
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4040
Mailing Address - Country:US
Mailing Address - Phone:918-786-0017
Mailing Address - Fax:
Practice Address - Street 1:101 MILLER DR
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-6412
Practice Address - Country:US
Practice Address - Phone:405-238-2574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7862122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist