Provider Demographics
NPI:1982869665
Name:HIKADE, BROOKE ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:HIKADE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:BROOKE
Other - Middle Name:ELIZABETH
Other - Last Name:HIKADE MCNEIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2805 DAWSON ST
Mailing Address - Street 2:#101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3800
Mailing Address - Country:US
Mailing Address - Phone:907-562-6456
Mailing Address - Fax:907-562-0009
Practice Address - Street 1:2805 DAWSON ST
Practice Address - Street 2:#101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3800
Practice Address - Country:US
Practice Address - Phone:907-562-6456
Practice Address - Fax:907-562-0009
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2010-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK13521223G0001X
ORD91411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice