Dallas Hale Hickle, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

29153 Issued in CA

Practice address

1615 Hill Rd
Ste. 12
Novato, CA 94947-4340

Phone

(415) 892-1564

Fax

(415) 892-1566

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033256227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 HILL RD",
            "address_2": "STE. 12",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474340",
            "telephone_number": "415-892-1564",
            "fax_number": "415-892-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HILL RD",
            "address_2": "STE. 12",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474340",
            "telephone_number": "415-892-1564",
            "fax_number": "415-892-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLE",
        "first_name": "DALLAS",
        "middle_name": "HALE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "29153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Brian Heslip, D.C.
• Tracey Michelle Hessel, M.D.
• Natalie Hession, SLP
• Larry Kenneth Hetrick Jr., M.D.
• Christina Hetzer
• Gregory Thomas Hinman, 225400000X
• Bashar Hinnawi, DMD
• Hired Hands Inc.
• Kimmi Hoang, PHARMD.
• Nicholas Sean Hoehnle, MD

• Oral and Maxillofacial Surgery (Dentist) in Novato, CA
• Providers in Novato, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.