Brian Leroy Henningsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

013482 Issued in MO

Practice address

1600 B Southwest Blvd
Jefferson City, MO 65109

Phone

(573) 635-4852

Fax

(573) 635-1167

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Brian L Henningsen DDS PC

  • Dentist
  • Jefferson City, MO
  • NPI 1215099437
  NPD (past) Authorized official

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033158993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 B SOUTHWEST BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "573-635-4852",
            "fax_number": "573-635-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 B SOUTHWEST BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "573-635-4852",
            "fax_number": "573-635-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGSEN",
        "first_name": "BRIAN",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Helmig, MS CCC-SLP
• Help at Home, LLC
• Help at Home, LLC
• Samantha Rose Helton, MS, CCC-SLP
• Gary Wayne Hemphill
• Jacqueline Henry, PHD
• Nelson Henry, DDS
• Teri Hensley
• Lauren Henson, LPN
• Sarah Jean Hentges, LPN

• General Practice Dentistry in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.