Henry Polk Dental Group, DPC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HENRY POLK DENTAL GROUP, DPC

Practice address

8110 Cordova Rd
Suite 125
Cordova, TN 38016-0520

Phone

(901) 755-0001

Fax

(901) 755-9679

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Reagan Johnson

Title

Financial Coordinator

Phone

(901) 755-0001

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Henry, DDS

  • General Practice Dentistry
  • Bartlett, TN
  • NPI 1932284999
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043395023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 CORDOVA RD",
            "address_2": "SUITE 125",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160520",
            "telephone_number": "901-755-0001",
            "fax_number": "901-755-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 CORDOVA RD",
            "address_2": "SUITE 125",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160520",
            "telephone_number": "901-755-0001",
            "fax_number": "901-755-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY POLK DENTAL GROUP, DPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "REAGAN",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "901-755-0001",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendrick Knoll Henderson, MD
• Lori Yvette Henderson, FNP-C
• Tiara Henderson
• Ebonique Hendricks, BS, OTR/L
• Barbara T Henking, PHD
• Pauline Hensley, M.S., CCC-SLP
• Jennifer Henson, O.D
• Ami L Herbstrith, DPM
• Alicia Hernandez Sosa
• Jonathan Hernandez, DDS

• General Practice Dentistry in Cordova, TN
• Providers in Cordova, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.