DR. JUDSON STEPHEN HICKEY (NPI# 1033152988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033152988 |
| Entity Type | Individual |
| Full Name | DR. JUDSON STEPHEN HICKEY |
| Credential | D.M.D. |
| Practice Address |
2315 Central Ave Suite B Augusta GA 30904-6272 |
| Practice Telephone | 7067390071 |
| Practice Fax Number | 7067390820 |
| Mailing Telephone | 7067390071 |
| Mailing Fax Number | 7067390820 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN009167 | GA | Dental Providers |
| Street Address |
2315 CENTRAL AVE SUITE B |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-6272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912241654 | Tracy Middlebrooks, Md | Pediatrics | 2315 Central Ave, Augusta, GA 30904-6272 | 2012-11-19 |
| 1992897714 | Tracy Williams Middlebrooks Jr. | Pediatrics | 2315 Central Ave, Augusta, GA 30904-6272 | 2006-09-29 |
| 1952317240 | Jennifer Lynn Jones | Speech-Language Pathologist | 2315 Central Ave, Bldg C, Augusta, GA 30904-6272 | 2006-07-31 |
| 1679502991 | Brooke Daniel | Physical Therapist | 2315 Central Ave, Augusta, GA 30904-6246 | 2006-06-30 |
| 1194751511 | Meliha Amerson | Occupational Therapist | 2315 Central Ave, Augusta, GA 30904-6246 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420146 | Scott Hansen Lowry | Dentist | 1430 John Wesley Drive, Augusta, GA 30912-0001 | 2020-02-25 |
| 1871948695 | Kyle Garrett | Dentist | 2704 W Terrace Dr, Augusta, GA 30909-3622 | 2016-04-29 |
| 1841507928 | Cristiano Susin | Dentist | 1120 15th St # Ad1430, Mcg School of Dentistry Dept Periodontics, Augusta, GA 30912-0004 | 2010-09-09 |
| 1699810366 | Christopher William Cutler | Dentist | 1120 15th St # Gc-1335, Ghsu-college of Dental Medicine, Augusta, GA 30912-0004 | 2007-02-21 |
| 1891846754 | David W. Perrry | Dentist | 231 Davis Rd, Augusta, GA 30907-2407 | 2007-01-16 |
| 1952465742 | Jeffrey Jerome Dent | Dentist | 1238 Augusta West Pkwy, Augusta, GA 30909-1854 | 2006-12-19 |
| 1891714135 | Mark A Brunner | Dentist | 1430 John Wesley Gilbert Dr., Gc-1333, Augusta, GA 30327-3007 | 2006-07-18 |
| 1417900929 | Philip J Hanes | Dentist | 1430 John Wesley Gilbert, Gc-1024, Augusta, GA 30912-1001 | 2006-05-18 |
| 1073112512 | Celine Joyce Cornelius Timothius | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2020-10-24 |
| 1144671397 | Mira Ghaly | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2016-06-29 |
| Find all providers in AUGUSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.