Kristin Wayne Hendricks, DDS
Individual provider Active NPI Pediatric Dentistry · Santa Fe, NM
NPI 1023320165 · NPPES record last updated Jan 14, 2025
Key facts
- NPI
- 1023320165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- DDS109479 (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
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS109479 | CA | MD | Pediatric Dentist |
| DD3267 | NM | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hendricks Functional Health, LLC | Current | Accepting new patients | |
| Hendricks Ca Dental Group, Inc | Pediatric Dentistry | Current | Accepting new patients |
| Whole Child Dental, LLC | Pediatric Dentistry | Current |
Accepting new patients |
| Taos Health Systems, Inc., Holy Cross Hospital | Past | Accepting new patients |
Locations
3661 Torrance Blvd
Ste 105
Torrance, CA 90503
Phone (310) 543-3292
2904 Rodeo Park Dr E
Ste 300B
Santa Fe, NM 87505
Phone (505) 216-3466
1439 S Saint Francis Dr
Santa Fe, NM 87505
Phone (505) 473-5437
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DD3267 | NM | |
| Pediatric Dentistry | 1223P0221X | DDS109479 | CA | Yes |
Addresses
Primary practice location
1439 S Saint Francis Dr
Santa Fe, NM 87505-4037
Mailing address
1439 S Saint Francis Dr
Santa Fe, NM 87505-4037
Phone (505) 473-5437
Other providers in Santa Fe, NM
- Hendricks Dental Group, LLC
- Hendricks Functional Health, LLC
- Allison Denise Hendricks
- Katharine Hope Hendricks
- Kelly Hendricks
- Helen Elizabeth Hendrickson
- Jaclyn Henley
- Robert Hennelly
- Kimberly Henning
- Julie Ann Henry
All providers in Santa Fe, NM · Pediatric Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.