Active NPI
Joseph E Hickey III, DDS
- Dentist
- Granger, IN
National Provider Identifier
1710187422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12011040
- Practice address
- 6910 N Main St
BLDG 1, Unit 58
Granger, IN 46530-9680 - Phone
- (574) 277-4235
- NPI assigned
- Jul 20, 2007
- Last updated
- Jun 1, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 12011040 | IN | Primary |
Addresses
Primary practice location
6910 N Main St
BLDG 1, Unit 58
Granger, IN 46530-9680
Mailing address
6910 N Main St
BLDG 1, Unit 58
Granger, IN 46530-9680
Phone (574) 277-4235
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12011040 | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granger Dental Group, LLC | Past | Accepting new patients | |
| Campbell Dental Group | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Granger, IN
- NPI 1245688282
-
- General Practice Dentistry
- Granger, IN
- NPI 1699894907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464739200000",
"number": "1710187422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6910 N MAIN ST",
"address_2": "BLDG 1, UNIT 58",
"city": "GRANGER",
"state": "IN",
"postal_code": "465309680",
"telephone_number": "574-277-4235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6910 N MAIN ST",
"address_2": "BLDG 1, UNIT 58",
"city": "GRANGER",
"state": "IN",
"postal_code": "465309680",
"telephone_number": "574-277-4235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKEY",
"first_name": "JOSEPH",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-20",
"last_updated": "2016-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12011040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granger, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.