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

Dr. Nicole Marie Sudholt, DMD

Individual provider Dentist · NPI 1184915431

Dr. Nicole Marie Sudholt, DMD is a Dentist in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011
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

843 W Glen Ave
Peoria, IL 61614-4834
Phone: (309) 691-9421
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019028323 (IL)

Record details

NPI number1184915431
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedApril 20, 2011
Last updated in NPPESApril 20, 2011

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