MEDICARE: BRIAN MICHAEL HIVICK D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30-023675	OH

General Provider Information

NPI Number	:	1669761086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN MICHAEL HIVICK D.D.S

Provider Business Mailing Address
First Line	:	1208 BELL RD
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44022-4254
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 BELL RD
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44022-4254
Country	:	US
Telephone Number	:	440-338-1711
Fax Number	:	440-338-5107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	07/12/2013

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1477729424 — GARY L. HOLTZ, D.D.S., INC.
Practice Location Address:

1208 BELL RD
CHAGRIN FALLS, OH
44022-4254

Practice Phone: 440-338-1711
Practice Fax: 440-338-5107

1326087545 — DR. GARY LEE HOLTZ D.D.S.
Practice Location Address:

1208 BELL RD
SOUTH RUSSELL, OH
44022-4254

Practice Phone: 440-338-1711
Practice Fax:

1780717322 — SEE OPPORTUNITIES AND ACHIEVE RESULTS
Practice Location Address:

1380 BENTON ST
IDAHO FALLS, ID
83401-4254

Practice Phone: 208-403-3472
Practice Fax: 208-522-2603

1245363639 — SEE OPPORTUNITIES AND ACHIEVE RESULTS
Practice Location Address:

1380 BENTON ST
IDAHO FALLS, ID
83401-4254

Practice Phone: 208-403-3472
Practice Fax: 208-522-2603

1861526345 — LEMHI VALLEY SOCIAL SERVICES, INC.
Practice Location Address:

1380 BENTON ST
IDAHO FALLS, ID
83401-4254

Practice Phone: 208-756-2927
Practice Fax: 208-756-1518

Directions to “ BRIAN MICHAEL HIVICK D.D.S” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.