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Deactivated NPI 1144718834 Deactivated / Inactive NPI Male Practitioner

Dr. Michael Ray Nicholson , DDS

Dentist - General Practice • Cerritos, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Michael Nicholson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 27, 2018
NPI Deactivation Date December 03, 2020
Total Practice Duration ~2 Years of Practice (2018 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Nicholson, DDS was a registered Dentist - General Practice practicing in Cerritos, CA. Throughout an active medical career spanning 2 years, Dr. Nicholson provided care at the practice location at 10929 SOUTH ST STE 106B until profile deactivation on 2020-12-03.

Practice Location & Contact Primary Location

Practice Address

10929 South St Ste 106b

Cerritos, CA 907035373

Telephone 8183982609
Fax 8187616490

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Cerritos, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
43 Specialists

Practicing in Cerritos, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 21927

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 03, 2020

Record deactivated on December 03, 2020

NPI Profile Active April 27, 2018

NPI status registered as active in NPPES database

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Updated Practice Location April 27, 2018

Registered at 10929 SOUTH ST STE 106B, CERRITOS, CA 907035373 (Tel: 8183982609)

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Updated Business Mailing Address April 27, 2018

Registered at 3530 MOUND VIEW AVE, STUDIO CITY, CA 916043624 (Tel: 8183982609)

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Provider Name / Credentials Updated April 27, 2018

Recorded as MICHAEL NICHOLSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2018

Dentist (License #21927 in CA)

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Initial NPI Registration & Enumeration April 27, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1144718834
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2018
Last Update: April 27, 2018
Deactivation Date: December 03, 2020

Mailing Address

3530 Mound View Ave

Studio City, CA 916043624

Phone: 8183982609

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.