Les J. Kicklighter, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

012401 Issued in GA

Practice address

512 Gentilly Rd
Statesboro, GA 30458-5149

Phone

(912) 489-4151

NPI assigned

Mar 26, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Practice roles

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.

• Les J. Kicklighter, D.M.D., P.C.

  • General Practice Dentistry
  • Statesboro, GA
  • NPI 1053442608
  NPD (past) Authorized official

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417075623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NOTTINGHAM TRL",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584265",
            "telephone_number": "912-489-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 GENTILLY RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585149",
            "telephone_number": "912-489-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKLIGHTER",
        "first_name": "LES",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "012401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00956007A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxwell B Kennedy, MFT
• Sarah Kent, IBCLC
• Isabella Kersey
• Katherine Elizabeth Key
• Mbill Shadman Khan
• Kidz Therapies of Statesboro
• Noah Thomas Kilday, DC
• Killian Hill RX LLC (Killian Hill Pharmacy)
• Taylor Kimbrell
• John Edward Kimes, PT

• General Practice Dentistry in Statesboro, GA
• Providers in Statesboro, GA by specialty
• General Practice Dentistry in Georgia

• 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.
• 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.