Jeffrey Martin Henkin, DDS, MS, FICD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

19A14070 Issued in IL

Practice address

24860 Taylor St
Loma Linda, CA 92350-0001

Phone

(909) 558-4610

Fax

(909) 558-4801

NPI assigned

Dec 4, 2006

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1033277934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24860 TAYLOR ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4610",
            "fax_number": "909-558-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24860 TAYLOR ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4610",
            "fax_number": "909-558-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKIN",
        "first_name": "JEFFREY",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, FICD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "19A14070",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "56670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph James Hemry, MD
• Breana Henderson
• Melissa D Hendricks
• Sean Hendrix
• Heather Elaine Henken, M.D.
• Christine Natalie Renee Henry, CRNP
• Gina Henry
• Allison Hensley, M.D.
• Heritage Health Care, Inc.
• Heritage Health Care, Inc.

• Periodontics in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.