Jason Dewayne Nicholson, DDS is a
Dentist based in Benton, Tennessee. Jason Dewayne Nicholson is licensed to practice in Tennessee (license number 7391) and his current practice location is
6151 Hwy 411, Benton, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(423) 338-8519.
NPI number for Jason Dewayne Nicholson is 1053446450 and his current mailing address is Po Box 669, Benton, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1053446450.
Healthcare Provider's Profile
| Full Name | Jason Dewayne Nicholson |
|---|
| Gender | Male |
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| Speciality | Dentist |
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| Location | 6151 Hwy 411, Benton, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1053446450
- Provider Enumeration Date: 02/23/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Jason Dewayne Nicholson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053446450 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 7391 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jason Dewayne Nicholson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jason Dewayne Nicholson, DDS
Po Box 669,
Benton, TN 37307
Ph: (423) 338-8519 | Jason Dewayne Nicholson, DDS
6151 Hwy 411,
Benton, TN 37307
Ph: (423) 338-8519 |
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