Active NPI
Jennifer Hicks, DMD
- Dentist
- Goodyear, AZ
National Provider Identifier
1992544068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D012134
- Practice address
- 500 N Estrella Pkwy Ste B1
Goodyear, AZ 85338-4136 - Phone
- (623) 882-0782
- NPI assigned
- May 20, 2024
- Sex
- Female
- Sole proprietor
- No
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 | D012134 | AZ | Primary |
Addresses
Primary practice location
500 N Estrella Pkwy Ste B1
Goodyear, AZ 85338-4136
Mailing address
744 E Hayward Ave
Phoenix, AZ 85020-4149
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 |
|---|---|---|---|
| D012134 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Identity Dental Specialties | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Phoenix, AZ
- NPI 1275484495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1992544068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "744 E HAYWARD AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850204149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N ESTRELLA PKWY STE B1",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853384136",
"telephone_number": "623-882-0782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "JENNIFER",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-20",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D012134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.