Kristin Wayne Hendricks, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS109479 Issued in CA

Practice address

1439 S Saint Francis Dr
Santa Fe, NM 87505-4037

Phone

(505) 473-5437

Fax

(505) 438-3443

NPI assigned

Jul 6, 2010

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Whole Child Dental, LLC

  dba Dentistry For Kids

  • Pediatric Dentistry
  • Santa Fe, NM
  • NPI 1255639621
  NPD Authorized official
• Hendricks Functional Health, LLC

  dba Santa Fe Therapy Associates

  • Speech-Language Pathologist
  • Santa Fe, NM
  • NPI 1942958277
  NPD
• Hendricks Ca Dental Group, Inc

  dba Dentistry for Kids

  • Pediatric Dentistry
  • Torrance, CA
  • NPI 1316719438
  NPD
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1023320165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 S SAINT FRANCIS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054037",
            "telephone_number": "505-473-5437",
            "fax_number": "505-438-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 S SAINT FRANCIS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054037",
            "telephone_number": "505-473-5437",
            "fax_number": "505-438-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "KRISTIN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD3267",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS109479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hendricks Dental Group, LLC
• Hendricks Functional Health, LLC (Santa Fe Therapy Associates)
• Allison Denise Hendricks, LMHC
• Katharine Hope Hendricks, LPCC
• Kelly Hendricks
• Helen Elizabeth Hendrickson, M.D.
• Jaclyn Henley
• Robert Hennelly, MA
• Kimberly Henning
• Julie Ann Henry

• Pediatric Dentistry in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Pediatric Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.