Katherine Vasiliki Hicks, DMD
Individual provider Active NPI General Practice Dentistry · Neptune Beach, FL
NPI 1407902893 · NPPES record last updated Jan 29, 2015
Key facts
- NPI
- 1407902893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN17174 (FL)
- Practice address
- 630 Atlantic Blvd
Suite 7
Neptune Beach, FL 32266-4000 - Phone
- (904) 247-2626
- Fax
- (904) 998-7702
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN17174 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surfside Dental Specialist | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN17174 | FL | Yes |
Addresses
Primary practice location
630 Atlantic Blvd
Suite 7
Neptune Beach, FL 32266-4000
Mailing address
3545-1 St. Johns Bluff Rd. S.
Suite 352
Jacksonville, FL 32224
Phone (904) 998-7000
Other names
- Katherine Vasiliki Hill
Other providers in Neptune Beach, FL
- John Eric Haas
- Chrisoula Marie Harris
- Helena Health LLC
- Richard Scott Herbert
- Matthew Hickman
- Donatella Bellamia Hill
- Holiday CVS LLC
- Homecall MD LLC
- Judi Anne Howard
- Joann Hoza
All providers in Neptune Beach, FL · General Practice Dentistry in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.