Provider Demographics
NPI:1538736251
Name:NIXON, MAKAYLA (DMD)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:NIXON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6008 KELLY CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:AL
Mailing Address - Zip Code:35004-2151
Mailing Address - Country:US
Mailing Address - Phone:404-884-1924
Mailing Address - Fax:
Practice Address - Street 1:15 12TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1977
Practice Address - Country:US
Practice Address - Phone:256-586-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD-0006905-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist