Jerry Richard Hickman, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12006199A Issued in IN

Practice address

8001 Shelby St
Suite 1
Indianapolis, IN 46227-5970

Phone

(317) 888-7807

Fax

(317) 888-0083

NPI assigned

Sep 11, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Hickman Orthodontic

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Indianapolis, IN
  • NPI 1619163045
  NPD (past)
• Orthodontic Partners of Indiana, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Noblesville, IN
  • NPI 1942089081
  NPD (past)

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1780879981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 SHELBY ST",
            "address_2": "SUITE 1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462275970",
            "telephone_number": "317-888-7807",
            "fax_number": "317-888-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 SHELBY ST",
            "address_2": "SUITE 1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462275970",
            "telephone_number": "317-888-7807",
            "fax_number": "317-888-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "JERRY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12006199A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary F Hickel, NP
• Andrea Hickle, LCSW
• Shelby Marie Hickle, ATC
• Hickman Orthodontic
• Horace O. Hickman Jr., M.D., J.D.
• John Hickman, RBT
• Laura Hickman
• Leslie A Hickman, LMHC
• Michelle Hickman, BCBA
• Todd Andrew Hickman, DDS, MSD

• Orthodontics and Dentofacial Orthopedics Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.