David Mark Hicklin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4261 Issued in SC

Practice address

10 Richland Medical Park Dr Ste a
Columbia, SC 29203-6892

Phone

(803) 434-6565

Fax

(803) 434-6299

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1740312982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-434-6565",
            "fax_number": "803-434-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 RICHLAND MEDICAL PARK DR STE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036892",
            "telephone_number": "803-434-6565",
            "fax_number": "803-434-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4261",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Heyward, LISW-CP
• Marquita Heyward, LPC-I
• Regina Heyward, THERAPIST
• Tinesha Sierra Heyward
• Kaitlyn Rose Hickey, PA
• Laura Hicklin, MSP, CCC-SLP
• E Gayle Hickman, LISW CP AP
• Lynn Hicks-Snoddy, MD
• Andryel Louise Hicks-Walker, RDN
• Anna Amberg Hicks

• General Practice Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.