GINA M NICOLOSO (NPI# 1417487224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417487224 |
| Entity Type | Individual |
| Full Name | GINA M NICOLOSO |
| Practice Address |
3120 Mahan Drive Tallahassee FL 32308 |
| Practice Telephone | (217) 540-5100 |
| Practice Fax Number | 8776353298 |
| Mailing Telephone | 2175405100 |
| Mailing Fax Number | 8776353298 |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN22618 | FL | Dental Providers |
| Street Address |
3120 MAHAN DRIVE |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003344698 | George M Jusu | Dentist | 3120 Mahan Drive, Tallahassee, FL 32308 | 2017-05-26 |
| 1710407812 | Comfortable Care Denta Health Professionals, Pa | Dentist | 3120 Mahan Drive, Tallahassee, FL 32308 | 2017-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952896292 | Julio Alberto Sixto | Dentist | 2621 Mitcham Dr Ste 102, Tallahassee, FL 32308-5481 | 2018-06-28 |
| 1003344698 | George M Jusu | Dentist | 3120 Mahan Drive, Tallahassee, FL 32308 | 2017-05-26 |
| 1780064329 | Bennie Thompkins | Dentist | 535 Apple Yard Dr, Tallahassee, FL 32304 | 2015-06-08 |
| 1992111249 | Victoria Jones | Dentist | 1970 Gainsborough Dr, Suite 2, Tallahassee, FL 32311-2717 | 2014-07-08 |
| 1235473018 | Astrid Ivette Gonzalez | Dentist | 4052 Bald Cypress Way Bin A14, Dental Public Health Dept, Tallahassee, FL 32399-1724 | 2012-11-19 |
| 1013172808 | Ronald Gordan Willis Jr. | Dentist | 2470 Care Dr, Tallahassee, FL 32308-4579 | 2008-07-22 |
| 1447414248 | Ira John Seasholtz II | Dentist | 2003 Miccosukee Rd, Tallahassee, FL 32308-5307 | 2008-07-11 |
| 1134301872 | Benjamin James Grooters | Dentist | 1318 E 6th Ave, Tallahassee, FL 32303-6506 | 2007-12-05 |
| 1891988531 | Michael Darrh Bryant | Dentist | 1234 Timberlane Rd, Tallahassee, FL 32312-1710 | 2007-08-27 |
| 1114119906 | Tom C Sexton | Dentist | 1384 Timberlane Rd, Tallahassee, FL 32312 | 2007-08-15 |
| Find all providers in TALLAHASSEE | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
Please comment or provide details below to improve the information on GINA M NICOLOSO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.