Provider Demographics
NPI:1356757769
Name:HINKLEY, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HINKLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6885 CASTLEROCK TRL APT D
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-6028
Mailing Address - Country:US
Mailing Address - Phone:303-204-2676
Mailing Address - Fax:
Practice Address - Street 1:6885 CASTLEROCK TRL APT D
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-6028
Practice Address - Country:US
Practice Address - Phone:303-204-2676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES 3417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist