Riley Jared Hicks, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12550699-9925 Issued in UT

Practice address

1255 Allen Way
Jackson, WY 83002-8300

Phone

(307) 690-5990

NPI assigned

Oct 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gregory McGee, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Idaho Falls, ID
  • NPI 1477023778
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1659368447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11606",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830021606",
            "telephone_number": "307-690-5990",
            "fax_number": "208-528-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 ALLEN WAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830028300",
            "telephone_number": "307-690-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "RILEY",
        "middle_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D-3314-OS",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WY",
            "license": "1506",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "12550699-9925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary W Heath, MD
• Jeremy Stewart Hertzig, M.D.
• Maribeth L. Hesser, PSY.D
• Tracy Hiatt, ED.S. PPC
• Mark Lawrence Hibbard
• Christopher Clayton Hills, D.O.
• Rose Margaret Hochheiser, PSYD
• Christine Holding, LMFT
• Hole Ortho LLC
• Catherine Holland, RD, CDE, LD

• Oral and Maxillofacial Surgery (Dentist) in Jackson, WY
• Providers in Jackson, WY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.