Kevin J Wicks, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

041448 Issued in NY

Practice address

2860 Westinghouse Rd
Horseheads, NY 14845

Phone

(607) 796-2663

Fax

(607) 796-0064

NPI assigned

Aug 29, 2006

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

Medicare fee-for-service enrollment

Enrolled in NY

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

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1518076264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 CORNING RD",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149031047",
            "telephone_number": "607-796-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 WESTINGHOUSE RD",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "14845",
            "telephone_number": "607-796-2663",
            "fax_number": "607-796-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "041448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen F Wheelock, RPH
• Amy L White, M.D.
• Morgan White, LMSW
• Vickie Lynn White
• Victoria Whitford
• Wilke and Baker LLP (Gentle Family Dentistry)
• Charles Wilke, DDS
• Robert Franklin Williams III, LMT
• Trisha Suzanne Williams, M.P.T.
• Heidi Renee Wilson, M.D.

• Dentist in Horseheads, NY
• Providers in Horseheads, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.