Hickory St LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HICKORY ST LLC

Practice address

637 Hickory St NW Ste 110
Albany, OR 97321-1761

Phone

(541) 406-3500

NPI assigned

Jan 17, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Amanpreet Flynn, DDS

Title

Owner

Phone

(541) 406-3500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Springhill dental and Orthodontics Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aman K Grewal, D.D.S.,M.D.S.,B.D.S.

  • General Practice Dentistry
  • Albany, OR
  • NPI 1861621641
  NPD

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1245860345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 HICKORY ST NW STE 110",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211761",
            "telephone_number": "541-406-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 HICKORY ST NW STE 110",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211761",
            "telephone_number": "541-406-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY ST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "AMANPREET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-406-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82673551",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861621641",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130509300",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@springhilldentalortho.com",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "address_1": "637 Hickory St NW Ste 110",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Springhill dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Hernandez, CHW
• Samuel Marcos Hernandez
• Ashley Nicole Herndon-Dubra
• Jesse Albert Heuer, DO
• David Hickerson, BS, CADC II, QMHA
• Rita Virginia Hicks, MFT
• Jayson B Hieter, PA-C
• James E Hill, PA-C
• Megan Hill
• Melinda Hills

• General Practice Dentistry in Albany, OR
• Providers in Albany, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.