Individual provider Active NPI

Seth Hinckley, DMD

  • General Practice Dentistry
  • Kalispell, MT
National Provider Identifier
1104279108
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10497 Issued in OR
Practice address
1250 Burns Way Ste 2
Kalispell, MT 59901-3140
Phone
(406) 752-6776
Fax
(406) 752-6771
NPI assigned
Jul 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10497 OR Primary

Addresses

Primary practice location

1250 Burns Way Ste 2
Kalispell, MT 59901-3140

Mailing address

1250 Burns Way Ste 2
Kalispell, MT 59901-3140
Phone (406) 752-6776

Other practice location 1

913 A St
Myrtle Point, OR 97458-1334
Phone (888) 468-0022 ext. 61881

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
D10497ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Big Heart Family Dentistry, PLLC CurrentSince Feb 9, 2020 Accepting new patients
Gabriel R Perjessy General Practice PastSince Feb 9, 2020 Accepting new patients

Locations

1250 Burns Way
Ste 2
Kalispell, MT 59901
Phone (406) 752-6776

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1104279108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 BURNS WAY STE 2",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013140",
            "telephone_number": "406-752-6776",
            "fax_number": "406-752-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BURNS WAY STE 2",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013140",
            "telephone_number": "406-752-6776",
            "fax_number": "406-752-6771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 A St",
            "address_purpose": "LOCATION",
            "city": "Myrtle Point",
            "state": "OR",
            "postal_code": "974581334",
            "country_code": "US",
            "telephone_number": "888-468-0022 x61881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINCKLEY",
        "first_name": "SETH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.