Kevin B Hericks, DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

M880 Issued in SD

Practice address

415 16TH Ave Cir NE
Watertown, SD 57201

Phone

(605) 886-2222

Fax

(605) 884-0074

NPI assigned

Feb 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

Locations

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.

• Dr. Kevin B Hericks DDS PC

  • General Practice Dentistry
  • Watertown, SD
  • NPI 1023685310
  NPD Authorized official
• Steven R Yseth DDS PC

  • General Practice Dentistry
  • Watertown, SD
  • NPI 1629645924
  NPD

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184762338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 427",
            "address_2": "415 16TH AVE CIR NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-886-2222",
            "fax_number": "605-884-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 16TH AVE CIR NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-886-2222",
            "fax_number": "605-884-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERICKS",
        "first_name": "KEVIN",
        "middle_name": "B",
        "credential": "DDS PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "M880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Hendricks, FNP-C
• Lee Matthew Hendricks, PSY.D.
• Michael Alan Hendricks, DC
• Jennifer Henrichs, R.N.
• Eve Lynn Hensler, AUDIOLOGIST
• Georgia A Hetland, RPH
• Misty Dawn Blough Hildenbrand, MS, RD, LN
• Nicole M Hirsch, CRNA
• Todd Hodenfield, PT, DPT
• Allen L Hoekman, MD

• Dentist in Watertown, SD
• Providers in Watertown, SD by specialty
• Dentist in South Dakota

• 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.