Nissen, Richard James
Nissen, Richard James is an sole proprietor health care provider with primary practice located at 31 The Boulevard-St. Louis , Saint Louis MO 63117. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Nissen, Richard James can be contacted via phone (314) 727-6162.Contact Information
Primary practice address
31 The Boulevard-St. Louis
Saint Louis MO 63117
Phone: (314) 727-6162
Fax: (314) 727-7259
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 14094 | Missouri |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 014094 | Missouri |
Profile Details
| NPI number | 1215046008 |
|---|---|
| LBN Legal business name | Nissen, Richard James |
| Credentials | DDS, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2006 |
| Last updated | Apr 16th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215046008 | NPPES |
| Missouri | Other | 14094 | STATE LICENSE |
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