Active NPI
Anna Louise Hicklin, DMD
- Dentist
- Greenville, SC
National Provider Identifier
1578875241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6907
- Practice address
- 415 Farrs Bridge Rd
Attn: Anna Louise Hicklin, DMD
Greenville, SC 29617-1858 - Phone
- (864) 246-2181
- NPI assigned
- Jul 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6907 | SC | Primary |
Addresses
Primary practice location
415 Farrs Bridge Rd
Attn: Anna Louise Hicklin, DMD
Greenville, SC 29617-1858
Mailing address
210 Lois St
Greenville, SC 29601-2919
Phone (803) 468-2379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140805000692 | SC | Order and Referring Only - Oral Surgery | 3779700455 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6907 | SC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336953600000",
"number": "1578875241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 LOIS ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012919",
"telephone_number": "803-468-2379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 FARRS BRIDGE RD",
"address_2": "ATTN: ANNA LOUISE HICKLIN, DMD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296171858",
"telephone_number": "864-246-2181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKLIN",
"first_name": "ANNA",
"middle_name": "LOUISE",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-09",
"last_updated": "2012-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "6907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.