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

Individual provider Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1093959660

Dr. Keith Nicholson, DDS is an Orthodontics and Dentofacial Orthopedics Dentistry in Philadelphia, Pennsylvania. Licensed in Indiana, Kentucky, North Carolina and Pennsylvania. Registered with an NPI since 2009.

Licensed in
IN, KY, NC, PA
In the registry since
2009
Specialties on file
5
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

100 S Broad St Ste 1530
Philadelphia, PA 19110-1026
Phone: (267) 691-0606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence DS043962 (PA)
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X · Licence 8795/879 (KY)
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X · Licence 8644 (NC)
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X · Licence 12012234A (IN)
Dentist Taxonomy 122300000X · Licence 8644 (NC)

Record details

NPI number1093959660
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 27, 2009
Last updated in NPPESMay 28, 2023
Certification dateMay 28, 2023

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