Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicholas Mickelson LLC

Organization Dental Clinic/Center · NPI 1679178271

Nicholas Mickelson LLC is a Dental Clinic/Center in Tampa, Florida. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13612 W Hillsborough Ave
Tampa, FL 33635-9638
Phone: (813) 444-7502
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1679178271
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Maisa Mickelson — Office Manager · (813) 616-9019
Other names Nova Dental
NPI enumeratedDecember 1, 2020
Last updated in NPPESDecember 1, 2020
Certification dateNovember 30, 2020
Mailing address8805 Rustic Trail Ct, Tampa, FL 33635-1557

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