Dr John R Licking, DDS - Medicare Dentist in Sunnyvale, CA

Dr John R Licking, DDS is a medicare enrolled "Dentist - General Practice" provider in Sunnyvale, California. His current practice location is 1565 Hollenbeck Ave, Suite 118, Sunnyvale, California. You can reach out to his office (for appointments etc.) via phone at (408) 736-6255.

Dr John R Licking is licensed to practice in California (license number 21321) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376524140.

Contact Information

Dr John R Licking, DDS
1565 Hollenbeck Ave, Suite 118,
Sunnyvale, CA 94087-5922
(408) 736-6255
(408) 736-6100



Healthcare Provider's Profile

Full NameDr John R Licking
GenderMale
SpecialityDentist - General Practice
Location1565 Hollenbeck Ave, Sunnyvale, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1376524140
  • Provider Enumeration Date: 11/09/2005
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 0345554549
  • Enrollment ID: I20150731016489

Medical Identifiers

Medical identifiers for Dr John R Licking such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376524140NPI-NPPES
21321OtherCACA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice 21321 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr John R Licking is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr John R Licking, DDS
1565 Hollenbeck Ave, Suite 118,
Sunnyvale, CA 94087-5922

Ph: (408) 736-6255
Dr John R Licking, DDS
1565 Hollenbeck Ave, Suite 118,
Sunnyvale, CA 94087-5922

Ph: (408) 736-6255

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› Verified 4 days ago


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Practice Location: 990 W Fremont Ave, Suite Y, Sunnyvale, CA 94087
Phone: 408-735-7161    Fax: 408-735-7173

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