Active NPI
Travis Alan Hickok, DDS
- Dentist
- SLC, UT
National Provider Identifier
1376797944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7028948
- Practice address
- 50 N Medical Dr
SLC, UT 84132-0001 - Phone
- (801) 581-2220
- NPI assigned
- Nov 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7028948 | UT | Primary |
Addresses
Primary practice location
50 N Medical Dr
SLC, UT 84132-0001
Mailing address
4889 Woodhaven Dr
Taylorsville, UT 84123-4378
Phone (801) 541-2482
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7028948 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226275200000",
"number": "1376797944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4889 WOODHAVEN DR",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841234378",
"telephone_number": "801-541-2482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 N MEDICAL DR",
"city": "SLC",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "801-581-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKOK",
"first_name": "TRAVIS",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-10",
"last_updated": "2008-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "7028948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in SLC, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.