Provider Demographics
NPI:1568638781
Name:NIKKELS, MURIEL KAYE (DDS)
Entity type:Individual
Prefix:
First Name:MURIEL
Middle Name:KAYE
Last Name:NIKKELS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31773 TEMECULA PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2874
Mailing Address - Country:US
Mailing Address - Phone:951-302-8811
Mailing Address - Fax:951-302-0616
Practice Address - Street 1:31773 TEMECULA PKWY STE A
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2874
Practice Address - Country:US
Practice Address - Phone:951-302-8811
Practice Address - Fax:951-302-0616
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice