Kenneth Wayne Vansickle Jr., D.M.D

General Practice Dentistry · Santa Fe, NM

Individual Active NPI

NPI number 1033196118

Practice location

2008 Saint Michaels Dr
Suite B
Santa Fe, NM 87505-7682
Phone
(505) 474-4993
Fax
(505) 474-4973

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NPI record

NPI
1033196118
Entity type
Individual (Type 1)
Enumeration date
December 29, 2005
Last updated
April 23, 2013
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X DD2304 NM

Mailing address

16 Arcade Unit 198747
Nashville, TN 37219-1994
Phone
(615) 750-0343
Fax
(615) 986-1705

About Dr. Vansickle

Kenneth Wayne Vansickle Jr., D.M.D is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 2008 Saint Michaels Dr, Suite B, Santa Fe, NM 87505-7682. The NPI number 1033196118 was assigned on December 29, 2005 and the record was last updated on April 23, 2013.

Dr. Vansickle lists a license in the registry: #DD2304 (NM) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kenneth Wayne Vansickle Jr., D.M.D?

The NPI number is 1033196118.

What is the phone number of Dr. Vansickle?

The phone number listed for the practice location is (505) 474-4993.

Where is Dr. Vansickle located?

2008 Saint Michaels Dr, Suite B, Santa Fe, NM 87505-7682.

What is the taxonomy code for Dr. Vansickle?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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