P Praxis·MD
● Active Type 1 · Individual

MRS. Samantha Anne Nicolello, RDH

Specialist·Meridian, ID· NPI 1124736723 · Enumerated 2022 · 3 years on NPI
Nicolello is 1 of 14 specialist providers in Meridian and 1 of 305 in Idaho.
NPI age
3 years
Enumerated 2022-11-11
Primary specialty
Specialist
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-11-11
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 305 active specialist providers in Idaho.

NPI age
3 years
↓ 15 yr below median (18 yr)
State licenses
1 state
2% of peers hold multiple states
Subspecialties
1
In the 11% of peers with subspecialties

NPI lifetime · 2022 → 2026

2022-11Enumerated in NPPES
2022 2026

Where they practice

Practice location
4044 N Legacy Woods Ave
Meridian, ID 836464480
📞 2088710760
Mailing address
4044 N Legacy Woods Ave
Meridian, ID 836464480
📞 2088710760

Specialties

  • Specialist Primary
    An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
    ID license #DH-3204 taxonomy 174400000X
  • Dental Hygienist
    An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. ...
    ID license #DH-3204 taxonomy 124Q00000X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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