Individual provider Active NPI

Cheryl Lynn Sixkiller, D.D.S

  • General Practice Dentistry
  • Warm Springs, OR
National Provider Identifier
1104073568
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6074 Issued in OK
Practice address
1270 Kot-Num Rd
Warm Springs, OR 97761-1209
Phone
(541) 553-1196
Fax
(541) 553-2135
NPI assigned
Aug 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D9921 OR
General Practice Dentistry 1223G0001X 6074 OK Primary

Addresses

Primary practice location

1270 Kot-Num Rd
Warm Springs, OR 97761-1209

Mailing address

1270 Kot-Num Rd
Warm Springs, OR 97761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D9921ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1104073568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 KOT-NUM RD",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "97761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOT-NUM RD",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "977611209",
            "telephone_number": "541-553-1196",
            "fax_number": "541-553-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIXKILLER",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warm Springs, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.