Individual provider Active NPI

Samuel Perry Sikon, DDS

  • General Practice Dentistry
  • Dothan, AL
National Provider Identifier
1619677689
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D.007451-C1 Issued in AL
Practice address
2001 Alexander Dr
Dothan, AL 36301-3003
Phone
(618) 967-4105
NPI assigned
Mar 7, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D.007451-C1 AL Primary

Addresses

Primary practice location

2001 Alexander Dr
Dothan, AL 36301-3003

Mailing address

330 4TH St
Slocomb, AL 36375-6081
Phone (618) 967-4105

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

LicenseStateTypeSpecialty
D.007451-C1ALMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1619677689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 4TH ST",
            "city": "SLOCOMB",
            "state": "AL",
            "postal_code": "363756081",
            "telephone_number": "618-967-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ALEXANDER DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013003",
            "telephone_number": "618-967-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKON",
        "first_name": "SAMUEL",
        "middle_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D.007451-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.