What is Nicole Widjaja's NPI number?

Nicole Widjaja's National Provider Identifier (NPI) is 1063259356, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Nicole Widjaja's specialty?

Nicole Widjaja is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).

Where is Nicole Widjaja located?

Nicole Widjaja's practice location on file with NPPES is 1350 Upper Hembree Rd, Roswell, GA 30076-0928.

What is Nicole Widjaja's phone number?

The practice phone number listed in the NPPES registry for Nicole Widjaja is (678) 920-7675.

Is Nicole Widjaja's NPI active?

Yes — Nicole Widjaja's NPI (1063259356) is active in the NPPES registry as of the last update on 2024-07-12.

IndividualActive

Nicole Widjaja, DMD

NPI 1063259356 · General Practice Dentistry · Roswell, GA

Nicole Widjaja, DMD is a General Practice Dentistry provider in Roswell, GA (NPI 1063259356).

Provider details

NPI number: 1063259356
Entity type: Individual
Primary specialty: General Practice DentistryDental Providers
Credential: DMD
Sex: Female
Sole proprietor: No
License: DN123505 (GA)

Specialties & taxonomies

General Practice DentistryPrimary1223G0001XLicense DN123505 (GA)
Dental Providers

Profile Score

Established profile(56/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
1 yr in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

1350 Upper Hembree Rd

Roswell, GA 30076-0928

Phone: (678) 920-7675

Street-level locationGet directions

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Mailing address