Provider Demographics
NPI:1609162601
Name:DANIEL A. NIX DMD, P.C.
Entity type:Organization
Organization Name:DANIEL A. NIX DMD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NIX
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-836-6611
Mailing Address - Street 1:5750 BENTLEY WAY
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173
Mailing Address - Country:US
Mailing Address - Phone:205-655-5144
Mailing Address - Fax:205-655-2566
Practice Address - Street 1:5750 BENTLEY WAY
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173
Practice Address - Country:US
Practice Address - Phone:205-655-5144
Practice Address - Fax:205-655-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty