NPIMap

Organization Active NPI

Wiley M Elick, DDS, Inc

Doing business as Kids Dental Group

  • Dentist
  • Hanford, CA
National Provider Identifier
1912350364
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21245 Issued in CA
Legal business name
WILEY M ELICK, DDS, INC
Doing business as
Kids Dental Group
Practice address
833 Greenfield Ave
#105
Hanford, CA 93230-3672
Phone
(559) 582-0238
Fax
(559) 582-1365
NPI assigned
Jul 21, 2016
Organization subpart
Yes
Parent organization
WILEY M ELICK, DDS, INC.,DBA KIDS DENTAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Authorized official

Name
Dr. Wiley M Elick, DDS
Title
President
Phone
(559) 582-0238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 21245 CA Primary

Addresses

Primary practice location

833 Greenfield Ave
#105
Hanford, CA 93230-3672

Mailing address

833 Greenfield Ave
#105
Hanford, CA 93230-3672
Phone (559) 582-0238

Other names 1

  • Kids Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wiley M Elick DDS Inc2 organizations share this tax ID, including this one
Part of
Wiley M Elick DDS Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1912350364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 GREENFIELD AVE",
            "address_2": "#105",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303672",
            "telephone_number": "559-582-0238",
            "fax_number": "559-582-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 GREENFIELD AVE",
            "address_2": "#105",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303672",
            "telephone_number": "559-582-0238",
            "fax_number": "559-582-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILEY M ELICK, DDS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILEY M ELICK, DDS, INC.,DBA KIDS DENTAL GROUP",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "ELICK",
        "authorized_official_first_name": "WILEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-582-0238",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "21245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.