NPIMap

Individual provider Active NPI

Jeffery Hinckley, DMD

  • General Practice Dentistry
  • Wenatchee, WA
National Provider Identifier
1659594646
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60074986 Issued in WA
Practice address
600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800
Phone
(509) 662-6000
Fax
(509) 682-6296
NPI assigned
Apr 10, 2007
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D3977 ID
General Practice Dentistry 1223G0001X DE60074986 WA Primary

Addresses

Primary practice location

600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800

Mailing address

600 Orondo Ave
Ste 1
Wenatchee, WA 98801-2800
Phone (509) 662-3860

Other identifiers 1

IdentifierTypeStateIssuer
5059621MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160701001834 WA Order and Referring Only - DentistPractitioner - Dentist 6103118658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D3977IDMDGeneral Practice Dentistry
DE60074986WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Valley Community Health PastSince Nov 1, 2018 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Columbia Valley Community Health Children's ServicesWenatchee, WA, CCN 501882 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Nov 1, 2018
Nov 1, 2018
Columbia Valley Community HealthChelan, WA, CCN 501883 Federally qualified health center W-2 Managing Employee Nov 1, 2018
CVCH Behavioral HealthWenatchee, WA, CCN 501953 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Nov 1, 2018
Nov 1, 2018
Lincoln Elementary School ClinicWenatchee, WA, CCN 941053 Federally qualified health center W-2 Managing Employee Sep 3, 1976
Children's Behavioral HealthWenatchee, WA, CCN 941052 Federally qualified health center W-2 Managing Employee Nov 1, 2018
New PathWenatchee, WA, CCN 941054 Federally qualified health center W-2 Managing Employee Nov 1, 2018
Columbia Valley Community HealthEast Wenatchee, WA, CCN 501030 Federally qualified health center W-2 Managing Employee Nov 1, 2018
980 Psychiatric MedicalEast Wenatchee, WA, CCN 501066 Federally qualified health center W-2 Managing Employee Nov 1, 2018

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1659594646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE",
            "address_2": "STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-3860",
            "fax_number": "509-664-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000",
            "fax_number": "509-682-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINCKLEY",
        "first_name": "JEFFERY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3977",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60074986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5059621",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.