Matthew Blake Kickliter, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9493 Issued in TN

Practice address

1950 W Morris Blvd
Morristown, TN 37814-3764

Phone

(423) 586-8144

NPI assigned

Jul 18, 2012

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 names 1

• Dr. Matthew Kickliter Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1821343518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143764",
            "telephone_number": "423-586-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143764",
            "telephone_number": "423-586-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKLITER",
        "first_name": "MATTHEW",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "9493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "KICKLITER",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kenneth Mathews Jr MD PC
• Joshua Timothy Kenny, CPO
• Stacey Anne Kesterson, RNC MSN
• Kevin Catney, MD PLLC
• Amy Frances Keys, FNP-C
• Bridgette Parker Kidd
• Nyda Kidd
• Kidney Center PLLC
• Drew Thomas Kilday, PHARM. D
• Ben King, MSC

• General Practice Dentistry in Morristown, TN
• Providers in Morristown, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.