Kelly Ann Hicklin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59777 Issued in CA

Practice address

975 Kirman Ave
Dental Clinic
Reno, NV 89502

Phone

(562) 869-3037

NPI assigned

Jul 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1659684629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 KIRMAN AVE",
            "address_2": "DENTAL CLINIC",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89502",
            "telephone_number": "775-326-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 KIRMAN AVE",
            "address_2": "DENTAL CLINIC",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89502",
            "telephone_number": "562-869-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Caviglia Heydon
• Sandi Heying
• Amanda Hiatt
• Thomas Edward Hibbard Jr., DO
• Daemin Patrick Hickey, DPT
• Dawn Delena Hickman
• Lisa Hickman
• Nicole Hickok, D.C.
• Autumn Hicks
• Cassidy Brooke Hicks, PHARMD

• General Practice Dentistry in Reno, NV
• Providers in Reno, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.

Verify at the official NPI Registry.