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Contact Information

IRIS C MCNICHOLL, DDS
1481 WEST 10TH STREET
INDIANAPOLIS, IN46202
 Phone: 317-988-2733
 Fax: 317-988-5377
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for IRIS C MCNICHOLL · (Female)

NPI # 1003914110
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 09/20/2006
Last updated 01/06/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 12009732
  • IN Medicaid 200169270A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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