Provider Demographics
NPI:1437571411
Name:BELLO, NICHOLAS GEORGE (DMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:GEORGE
Last Name:BELLO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 DUCK POND RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-3113
Mailing Address - Country:US
Mailing Address - Phone:508-818-2155
Mailing Address - Fax:
Practice Address - Street 1:470 PATCHOGUE HOLBROOK RD
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-1625
Practice Address - Country:US
Practice Address - Phone:508-818-2155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN185-64451223G0001X
NY059091122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice