NPIMap

Organization Active NPI

Hicks & Hicks PA

  • General Practice Dentistry
  • Palatka, FL
National Provider Identifier
1922103274
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0013541 Issued in FL
Legal business name
HICKS & HICKS PA
Practice address
800 Zeagler Drive
Suite 330
Palatka, FL 32177
Phone
(386) 325-6000
Fax
(386) 325-9306
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Shannon K HicksNPI 1366691917
Title
Sec Treas
Phone
(386) 325-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN0013368 FL
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DN0013541 FL Primary

Addresses

Primary practice location

800 Zeagler Drive
Suite 330
Palatka, FL 32177

Mailing address

800 Zeagler Drive
Suite 330
Palatka, FL 32177
Phone (386) 325-6000

Other names 1

  • Hicks Dental Doing business as

National Provider Directory

National Provider Directory

Locations

800 Zeagler Dr
Ste 330
Palatka, FL 32177
Phone (386) 325-6000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922103274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ZEAGLER DRIVE",
            "address_2": "SUITE 330",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "32177",
            "telephone_number": "386-325-6000",
            "fax_number": "386-325-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ZEAGLER DRIVE",
            "address_2": "SUITE 330",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "32177",
            "telephone_number": "386-325-6000",
            "fax_number": "386-325-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKS & HICKS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SEC TREAS",
        "authorized_official_telephone_number": "386-325-6000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0013368",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0013541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hicks Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.