Provider Demographics
NPI:1598887960
Name:NITSCHKE, JAMES ROBINSON (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBINSON
Last Name:NITSCHKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SULLYS TRL
Mailing Address - Street 2:SUITE1
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4571
Mailing Address - Country:US
Mailing Address - Phone:585-385-5940
Mailing Address - Fax:
Practice Address - Street 1:115 SULLYS TRL
Practice Address - Street 2:SUITE 1
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4571
Practice Address - Country:US
Practice Address - Phone:585-385-5940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0404291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice