Provider Demographics
NPI:1699989327
Name:DR. NICK F. PISTO, DDS
Entity type:Organization
Organization Name:DR. NICK F. PISTO, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:F
Authorized Official - Last Name:PISTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-236-1990
Mailing Address - Street 1:1242 N EOLA RD STE D
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9409
Mailing Address - Country:US
Mailing Address - Phone:630-236-1990
Mailing Address - Fax:630-236-1987
Practice Address - Street 1:1242 N EOLA RD STE D
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9409
Practice Address - Country:US
Practice Address - Phone:630-236-1990
Practice Address - Fax:630-236-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty