MEDICARE: DR. RILEY JARED HICKS 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	D-3314-OS	ID
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	1506	WY
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	12550699-9925	UT

General Provider Information

NPI Number	:	1659368447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RILEY JARED HICKS D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 11606
Second Line	:
City	:	JACKSON
State	:	WY
Zip	:	83002-1606
Country	:	US
Telephone Number	:	307-690-5990
Fax Number	:	208-528-6399

Provider Business Practice Location Address
First Line	:	1255 ALLEN WAY
Second Line	:
City	:	JACKSON
State	:	WY
Zip	:	83002-8300
Country	:	US
Telephone Number	:	307-690-5990
Fax Number	:

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	04/20/2022

Similar Medicare Providers

1316158272 — JACKSON PEDIATRICS P.C.
Practice Location Address:

557 E. BROADWAY , 557 E. BROADWAY
JACKSON, WY
83001-8300

Practice Phone: 307-733-4627
Practice Fax: 307-733-5184

1154806917 — CHEYENNE LYN SYVERTSON-HAGESTUEN MSW
Practice Location Address:

501 S CACHE STREET
JACKSON, WY
83001-8300

Practice Phone: 307-733-7946
Practice Fax:

1427034180 — MARK SCHULTHEIS P.T., S.C.S.C.
Practice Location Address:

1090 S HIGHWAY 89
JACKSON, WY
83002

Practice Phone: 307-733-5577
Practice Fax: 307-733-5505

1851350292 — DR. DAVID J TOMLINSON M.D.
Practice Location Address:

625 E BROADWAY
JACKSON, WY
83002

Practice Phone: 307-739-7218
Practice Fax: 307-739-7446

1215988514 — RATHNA RAJU-SWAMI MD
Practice Location Address:

155 EAST PEARL STREET , SUITE 12
JACKSON, WY
83002

Practice Phone: 307-733-2350
Practice Fax: 307-733-2953

1063468270 — FRANCINE P BARTLETT P.T., A.T.C.
Practice Location Address:

120 WEST PEARL AVE
JACKSON, WY
83002

Practice Phone: 307-734-9129
Practice Fax:

Directions to “ DR. RILEY JARED HICKS 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.