Individual provider · Type 1 NPI
Samantha Anne Nicolello, RDH
Specialist · Meridian, ID
NPI number
1124736723
Active
Practice location
4044 N Legacy Woods Ave
Meridian, ID 83646-4480
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Hygienist | 124Q00000X | DH-3204 (ID) |
| Specialist Primary | 174400000X | DH-3204 (ID) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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About NPI 1124736723
Samantha Anne Nicolello, RDH's National Provider Identifier is 1124736723, issued on Nov 11, 2022. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Meridian, ID. The record was last updated on Nov 11, 2022.