Jonathan Hunter Hicklin, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4685 Issued in SC

Practice address

1803 Augusta St Ste a
Greenville, SC 29605-2980

Phone

(864) 272-3091

Fax

(864) 272-3093

NPI assigned

May 6, 2009

Last updated

Aug 6, 2012By the provider in NPPES

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

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reedy River Dentistry

  • Dental Clinic/Center
  • Greenville, SC
  • NPI 1962109595
  NPD Authorized official

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1982838884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 AUGUSTA ST STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296052980",
            "telephone_number": "864-272-3091",
            "fax_number": "864-272-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 AUGUSTA ST STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296052980",
            "telephone_number": "864-272-3091",
            "fax_number": "864-272-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKLIN",
        "first_name": "JONATHAN",
        "middle_name": "HUNTER",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-06",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Hicken, SLP
• Candice Stephan Hickey, CRNA
• Jacqueline Hickey
• Anna Louise Hicklin, DMD
• Elizabeth M Hicklin, CCC-SLP
• Brigid Hicks
• Faith W Hicks
• James Heath Hicks, CRNA
• Katherine Elizabeth Hicks, MD
• Kirsten Emory Hicks, DMD

• General Practice Dentistry in Greenville, SC
• Providers in Greenville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.