Active NPI
Yujin Hicks, DDS
- General Practice Dentistry
- Columbia, MD
National Provider Identifier
1528805199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18188
- Practice address
- 10630 Little Patuxent Pkwy Ste 104
Columbia, MD 21044-6209 - Phone
- (410) 690-4855
- NPI assigned
- Jul 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18188 | MD | Primary |
Addresses
Primary practice location
10630 Little Patuxent Pkwy Ste 104
Columbia, MD 21044-6209
Mailing address
7004 Mahant Way
Elkridge, MD 21075-5493
Phone (706) 577-5648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18188 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1528805199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7004 MAHANT WAY",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210755493",
"telephone_number": "706-577-5648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10630 LITTLE PATUXENT PKWY STE 104",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210446209",
"telephone_number": "410-690-4855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "YUJIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-11",
"last_updated": "2024-07-11",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "18188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.