John R Licking DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

JOHN R LICKING DDS INC

Practice address

877 W Fremont Ave
C3
Sunnyvale, CA 94087-2319

Phone

(408) 736-6255

Fax

(408) 736-6100

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John R Licking, DDS

Title

Pres

Phone

(408) 736-6255

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467533133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 W FREMONT AVE",
            "address_2": "C3",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872319",
            "telephone_number": "408-736-6255",
            "fax_number": "408-736-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 W FREMONT AVE",
            "address_2": "C3",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872319",
            "telephone_number": "408-736-6255",
            "fax_number": "408-736-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R LICKING DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LICKING",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "408-736-6255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Sunnyvale, CA
• Providers in Sunnyvale, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.