Active NPI
Kyle Ryan Hickman, DDS
- General Practice Dentistry
- Columbus, OH
National Provider Identifier
1003975368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21955
- Practice address
- 4345 N High St
Columbus, OH 43214 - Phone
- (614) 268-5250
- Fax
- (614) 268-1110
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21955 | OH | Primary |
Addresses
Primary practice location
4345 N High St
Columbus, OH 43214
Mailing address
4345 N High St
Columbus, OH 43214
Phone (614) 268-5250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 28, 2015 through Jul 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21955 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003975368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4345 N HIGH ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43214",
"telephone_number": "614-268-5250",
"fax_number": "614-268-1110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4345 N HIGH ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43214",
"telephone_number": "614-268-5250",
"fax_number": "614-268-1110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "KYLE",
"middle_name": "RYAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "21955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.