Christopher J Hickerson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60354 Issued in KS

Practice address

1861 E Madison Ave Ste 400
Derby, KS 67037-2166

Phone

(316) 789-6200

Fax

(316) 361-2635

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1417929035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 LOOKOUT CIR",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670379246",
            "telephone_number": "316-640-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 E MADISON AVE STE 400",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670372166",
            "telephone_number": "316-789-6200",
            "fax_number": "316-361-2635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 N Rock Rd",
            "address_2": "suite 100",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "KS",
            "postal_code": "670373584",
            "country_code": "US",
            "telephone_number": "316-789-9999",
            "fax_number": "316-789-9296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dakota Cole Hegi, DC
• Amanda Helms, APRN
• Jennifer Kay Hensley, SLP
• Logan Hernblom
• Nazanin Hessabi, OT
• Rhonda Newberry Hildreth, LSCSW
• Brandi S Hileman, AUD
• Kara Hixon
• Amie Holbrook, MPT
• Cynthia D Holcomb, LSCSW

• General Practice Dentistry in Derby, KS
• Providers in Derby, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.