JODY WICKS, D.D.S., INC. – NPI #1912054107
Clinic/Center

JODY WICKS, D.D.S., INC. is an AHC clinic located in RESEDA, CA. NPPES has assigned the NPI number 1912054107 to JODY WICKS, D.D.S., INC. on January 03, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JODY WICKS, D.D.S., INC. below.

NPI Profile for
JODY WICKS, D.D.S., INC.

NPI Number
1912054107
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JODY WICKS, D.D.S., INC.
Primary location
6915 RESEDA BLVD
SUITE 2
RESEDA, CA 91335-4214
Phone: (818) 881-8820 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JODY WICKS
DENTIST
Phone: (818) 881-8820
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 CA 033685

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.