Nicole Widjaja is a Roswell, Georgia based Dentist who is specialized in
General Practice Dentistry. She does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Nicole Widjaja is
DN123505 for General Practice Dentistry in Georgia. Her current practice location is
1350 Upper Hembree Rd, Roswell. Patients can reach her at
678-920-7675.
Nicole Widjaja is the primary dental care provider for patients of all ages. She is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Nicole Widjaja speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Nicole Widjaja |
| Specialization: | Dentist |
| Gender: | Female |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 1350 Upper Hembree Rd, Roswell,
Georgia, 30076-0928 |
| Phone: | 678-920-7675 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1063259356 |
| NPI Enumeration Date: | 12 Jul, 2024 |
| NPI Last Update On: | 12 Jul, 2024 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Nicole Widjaja are as mentioned below.
| License Number | Specialization | State | Status | |
| DN123505 | General Practice Dentistry | Georgia | Primary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1350 Upper Hembree Rd,
Roswell, Georgia |
| Zip: | 30076-0928 |
Patients can reach Nicole Widjaja at
1350 Upper Hembree Rd, Roswell, Georgia or can
call to book an appointment on 678-920-7675.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.