Robert Henner, DMD

Individual provider Active NPI General Practice Dentistry · Congers, NY

NPI 1023024296 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1023024296
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
026446 (NY)
Practice address
1 Sheridan Ave
Congers, NY 10920-2011
Phone
(845) 268-3828
Fax
(845) 268-0279
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160414000070 NY Order and Referring Only - Dentist
Practitioner - Dentist
0244538981

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DN6823FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Congers Dental Arts Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 026446 NY Yes
General Practice Dentistry 1223G0001X DN6823 FL

Addresses

Primary practice location

1 Sheridan Ave
Congers, NY 10920-2011

Mailing address

1 Sheridan Ave
Congers, NY 10920-2011
Phone (845) 268-3828

Other providers in Congers, NY

All providers in Congers, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.