HICKORY HILLS DENTAL CARE LLC (NPI# 1205301777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205301777 |
| Entity Type | Organization |
| Organization Name | HICKORY HILLS DENTAL CARE LLC |
| Practice Address |
1947 Florence Blvd Florence AL 35630-2729 |
| Practice Telephone | 2567668800 |
| Practice Fax Number | 2567668936 |
| Mailing Telephone | 2567668800 |
| Mailing Fax Number | 2567668936 |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | IAN KYLE FAWCETT (OWNER) |
| Authorized Official Telephone | 2567668800 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 207491 | 05 |
| Street Address |
1947 FLORENCE BLVD |
| City | FLORENCE |
| State | AL |
| Zip Code | 35630-2729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003969312 | Bruce D Evans | Dentist | 1947 Florence Blvd, Florence, AL 35630-2729 | 2007-01-19 |
| 1932467297 | Bruce D. Evans | Dentist | 1947 Florence Blvd, Florence, AL 35630-2729 | 2012-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880531 | Rachel E Belue | Counselor | 409 N. Court Street, Florence, AL 35630 | 2020-01-15 |
| 1154857746 | Danish Henry | Internal Medicine | North Alabama Medical Center, 1701 Veterans Dr, Florence, AL 35630 | 2017-05-03 |
| 1396118261 | Three Oaks Pharmacy LLC | Pharmacy | 861 Cox Creek Parkway, Florence, AL 35630 | 2015-11-02 |
| 1235501891 | Wellness Walk-in Clinic, LLC | Nurse Practitioner | 2612 Hough Road, Florence, AL 35630 | 2015-10-22 |
| 1972995207 | Elyse Angel | Pharmacist | 109 East Dr Hicks Blvd, Florence, AL 35630 | 2015-02-24 |
| 1750772380 | Whitlee Laina Kelley | Case Manager/Care Coordinator | 112 Titan Drive, Florence, AL 35630 | 2015-02-18 |
| 1942612155 | Hillary Jean Delarosa | Internal Medicine | 162 Titan Drive, Florence, AL 35630 | 2014-05-22 |
| 1952723678 | Sharron M Boatwright | Nurse Practitioner | 1949 Florence Boulevard, Occupational Health Center LLC, Florence, AL 35630 | 2014-01-15 |
| 1194160523 | Caryn Barnett | Physical Therapist | 412 S. Court Street, Suite 403, Florence, AL 35630 | 2013-04-29 |
| 1396074662 | Heather White Bryant | Counselor | 118 East Mobile St, Suite 106, Florence, AL 35630 | 2009-12-16 |
| Find all providers in zip 35630 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780176412 | Palmetto Smiles of Florence Pa | Clinic/Center | 1260 Celebration Blvd, Florence, SC 29501-5498 | 2018-05-30 |
| 1811405400 | Prime Pediatric Dentistry | Clinic/Center | 2420 Hoffmeyer Rd Unit A, Florence, SC 29501-7426 | 2018-01-17 |
| 1003050568 | G. Thomas Bryce, Jr., Dds Pa | Clinic/Center | 1509 W Palmetto St, Florence, SC 29501-4131 | 2009-04-28 |
| 1962554626 | Family Dental Care Associates Psc | Clinic/Center | 6616 Dixie Hwy, #1, Florence, KY 41042 | 2007-01-16 |
| 1265529820 | Matthew N. Wilbanks, Dmd, PC | Clinic/Center | 2801 W Mall Dr, Florence, AL 35630-1563 | 2006-10-06 |
| 1841232428 | Florence Dental Associates LLC | Clinic/Center | 2251 W Palmetto St, Florence, SC 29501 | 2006-06-11 |
| 1639716475 | Chad E. Clement, Dds, PC | Clinic/Center | 1256 Bay St, Florence, OR 97439-9648 | 2019-11-27 |
| 1306406350 | Florence Family Dental | Clinic/Center | 2138 Helton Dr, Florence, AL 35630-1449 | 2019-06-20 |
| 1598003832 | Pinnacle One Dental Group | Clinic/Center | 7766 Ewing Blvd, Floor 3, Florence, KY 41042-7537 | 2013-01-22 |
| 1003061250 | Florence Dental Pllc | Clinic/Center | 46 E 11th St, Florence, AZ 85232 | 2008-12-01 |
| Find all providers in FLORENCE | ||||
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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.