DR. TRAVIS ALAN HICKOK (NPI# 1376797944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376797944 |
| Entity Type | Individual |
| Full Name | DR. TRAVIS ALAN HICKOK |
| Credential | DDS |
| Practice Address |
50 N Medical Dr Slc UT 84132-0001 |
| Mailing Address |
4889 Woodhaven Dr Taylorsville UT 84123-4378 |
| Practice Telephone | 8015812220 |
| Mailing Telephone | 8015412482 |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2008-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 7028948 | UT | Dental Providers |
| Street Address |
50 N MEDICAL DR |
| City | SLC |
| State | UT |
| Zip Code | 84132-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242113 | Jarrett Henderson | Occupational Therapist | 50 N Medical Dr, Slc, UT 84132-0001 | 2020-10-14 |
| 1588288997 | Whitney Smith | Registered Nurse | 50 N Medical Dr, Slc, UT 84132-0001 | 2020-06-01 |
| 1043855752 | Jessica Elizabeth Smith | Occupational Therapist | 50 N Medical Dr, Slc, UT 84132-0001 | 2019-11-18 |
| 1033647839 | Paul Alan Arnold | Occupational Therapist | 50 N Medical Dr, Slc, UT 84132-0001 | 2017-05-24 |
| 1245683127 | Jennifer Lynne Merkley | Nurse Practitioner | 50 N Medical Dr, Slc, UT 84132-0001 | 2016-07-15 |
| 1336523430 | University of Utah Adult Services | Clinic/Center | 50 N Medical Dr, Slc, UT 84132-0001 | 2015-07-17 |
| 1427497296 | Lindsey Kaye German | Advanced Practice Midwife | 50 N Medical Dr, Slc, UT 84132-0001 | 2013-06-14 |
| 1659625770 | Daniel Knitz | Clinical Nurse Specialist | 50 N Medical Dr, Slc, UT 84132-0001 | 2012-10-29 |
| 1417258500 | University of Utah Health Care | General Acute Care Hospital | 50 N Medical Dr, Som 1r73, Slc, UT 84132-0001 | 2010-11-05 |
| 1942500574 | Kaylene Danae Farrington | Occupational Therapist | 50 N Medical Dr, Som 1r169, Slc, UT 84132-0001 | 2010-10-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162331 | Scott Andrew Rizzi | Student in an Organized Health Care Education/Training Program | 30 North 1900 East Som 4c116, Salt Lake City, UT 84132 | 2020-04-02 |
| 1609421403 | Monika Fleckenstein | Ophthalmology | 65 Mario Capecchi Drive, John A. Moran Eye Center, Salt Lake City, UT 84132 | 2019-08-08 |
| 1366975914 | Jacob Brandenburg | Anesthesiology | School of Medicine 30 North 1900 East Room 3c444, Salt Lake City, UT 84132 | 2017-04-10 |
| 1568815082 | Anastasia Neufeld | Ophthalmology | 65 Mario Capecchi Drive, Salt Lake City, UT 84132 | 2016-07-20 |
| 1912350083 | Gmaan Alzhrani | Student in an Organized Health Care Education/Training Program | 175 N. Medical Drive East , Salt Lake City, UT 84132 | 2016-07-13 |
| 1831544600 | Drew Goerke | Occupational Therapist | 50 N Medical Drive, Som Room #1r73, Salt Lake City, UT 84132 | 2016-04-29 |
| 1891179024 | Bong Jik Kim | Student in an Organized Health Care Education/Training Program | 50 North Medical Drive 3c120, Otolaryngology Administration Office, Salt Lake City, UT 84132 | 2015-07-17 |
| 1043699101 | Chris Anderson | Physician Assistant | 30 North 1900 East #3c344, Salt Lake City, UT 84132 | 2015-05-22 |
| 1689061822 | Ryan Clark | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30 N 1900 E Som 3c127, Salt Lake City, UT 84132 | 2015-04-24 |
| 1649666264 | Kevin Conrad | Anesthesiology | 30 N 1900 E Room 3c444, Salt Lake City, UT 84132 | 2015-04-09 |
| Find all providers in zip 84132 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851555650 | Jared Maughan Weaver | Dentist | 2011 S 1300 E, Slc, UT 84105-3613 | 2008-07-11 |
| 1689705782 | Richard Dale Martinez | Dentist | 2936 Highland Dr Ste 101, Slc, UT 84106-3583 | 2007-03-08 |
| 1750444949 | Daniel W Ormsby | Dentist | 4578 So Highland Dr #350, Slc, UT 84117 | 2006-12-18 |
| 1932260528 | Todd S Suekawa | Dentist | 2178 S 900 E Suite 5, Slc, UT 84106-2388 | 2006-12-13 |
| 1063419125 | Heather Anne Crouch | Dentist | 1365 W 1000 N, Slc, UT 84116-1654 | 2005-07-05 |
| 1568469617 | Adon Emery Crook | Dentist | 461 S 400 E, Slc, UT 84111-3302 | 2005-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295335404 | Ida Nourbakhsh | Dentist | 1947 E Redondo Ave, Salt Lake City, UT 84108-3119 | 2020-10-27 |
| 1902410947 | Creek Dental Group Meadowbrook LLC | Dentist | 1148 E Ut-193, Layton, UT 84040 | 2020-09-08 |
| 1689282089 | Nathan Elmer Kobold | Dentist | 188 E 2050 S Apt B4, Bountiful, UT 84010-5456 | 2020-07-21 |
| 1205454113 | Dylan Lane Harmon | Dentist | 1445 N 400 E # 3a, North Logan, UT 84341-7564 | 2020-07-07 |
| 1902420318 | Cory Johnson | Dentist | 170 E Commonwealth Ave, South Salt Lake, UT 84115-2712 | 2020-06-01 |
| 1538783196 | Trevor Garrett | Dentist | 182 Ashe Dr, Brigham City, UT 84302-2788 | 2020-05-29 |
| 1538796818 | Andrew Phillips | Dentist | 2070 S View St Apt 113, Salt Lake City, UT 84105-3766 | 2020-03-25 |
| 1306499249 | Abundant Dental Care, P.C. | Dentist | 5089 West 12600 South, Herriman, UT 84096 | 2019-07-19 |
| 1770135923 | Mcconnell Dental Care IIi | Dentist | 263 Country Clb Ste 102, Stansbury Park, UT 84074-9602 | 2019-07-09 |
| 1700446267 | Michael Wagner | Dentist | 754 S Main St Ste 1, St George, UT 84770-5510 | 2019-06-17 |
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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.