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

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1790001436

Dr. Nicole Marie Reddout, DMD is an Oral Surgery in Norfolk, Virginia. Qualified in 2010, 16 years ago. Practices with Roanoke Oral Surgery Inc, a 4-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
16
Licensed in
VA
In the registry since
2010
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803
Phone: (757) 953-8605
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 0438000368 (VA)
Dentist Taxonomy 122300000X · Licence 0401415421 (VA)

Record details

NPI number1790001436
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedApril 19, 2010
Last updated in NPPESJanuary 30, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Also practisesMAXILLOFACIAL SURGERY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Roanoke Oral Surgery Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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