Active NPI
Andrew Kicklighter, DMD
- Dentist
- Byron, GA
National Provider Identifier
1841711272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN015421
- Practice address
- 3208 US Highway 41 N
Byron, GA 31008-3721 - Phone
- (478) 953-7770
- NPI assigned
- Jul 7, 2017
- Last updated
- Jul 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | DN015421 | GA | Primary |
Addresses
Primary practice location
3208 US Highway 41 N
Byron, GA 31008-3721
Mailing address
2122 Bethel Rd
Sycamore, GA 31790-2814
Phone (229) 567-4295
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 |
|---|---|---|---|
| DN015421 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499385600000",
"number": "1841711272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 BETHEL RD",
"city": "SYCAMORE",
"state": "GA",
"postal_code": "317902814",
"telephone_number": "229-567-4295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3208 US HIGHWAY 41 N",
"city": "BYRON",
"state": "GA",
"postal_code": "310083721",
"telephone_number": "478-953-7770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KICKLIGHTER",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-07",
"last_updated": "2017-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN015421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Byron, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.