Dustin Nielsen Hickman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11750 Issued in NC

Practice address

150 Veterans Blvd
Bryson City, NC 28713-8817

Phone

(772) 532-9879

NPI assigned

Oct 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Coast Florida P.a.

  dba Coast Dental-Orange City

  • Dentist
  • Orange City, FL
  • NPI 1427624840
  NPD (past)
• Coast Florida P.a.

  • Dentist
  • Tampa, FL
  • NPI 1730287673
  NPD (past)

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1396210266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VETERANS BLVD",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "287138817",
            "telephone_number": "772-532-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VETERANS BLVD",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "287138817",
            "telephone_number": "772-532-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "DUSTIN",
        "middle_name": "NIELSEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-08",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "23791",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis M Harrison, LIC. ACUPUNCTURIST
• Kaylee Burroughs Harvey, LCSW-A
• Hawthorn Heights WNC
• Healthstat Onsite Clinic Consolidated Metco Bryson City
• George Heilner, MA
• Brandi Jenkins, CADC
• David Andrew Johnston, MD
• Tammy Jernigan Johnston, MD
• Paul Joseph Keane, DPM
• Kerr Drug Inc (Kerr Drug)

• General Practice Dentistry in Bryson City, NC
• Providers in Bryson City, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.