Individual provider Active NPI

Hohete Yohannes Hendrix, DMD;MSD

  • Dentist
  • New Albany, IN
National Provider Identifier
1053583161
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011079A Issued in IN
Practice address
2676 Charlestown Rd Ste 1
New Albany, IN 47150-2574
Phone
(317) 224-8579
NPI assigned
Mar 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011079A IN Primary

Addresses

Primary practice location

2676 Charlestown Rd Ste 1
New Albany, IN 47150-2574

Mailing address

2676 Charlestown Rd Ste 1
New Albany, IN 47150-2574
Phone (812) 945-5533

Other practice location 1

8845 Boehning Ln
Indianapolis, IN 46219-1974
Phone (317) 899-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317000829 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698092476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011079AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
J Michael Williams DMD LLC Past Accepting new patients
River Falls Family Dental Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053583161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2676 CHARLESTOWN RD STE 1",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502574",
            "telephone_number": "812-945-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2676 CHARLESTOWN RD STE 1",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502574",
            "telephone_number": "317-224-8579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8845 Boehning Ln",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462191974",
            "country_code": "US",
            "telephone_number": "317-899-1112",
            "fax_number": "317-899-1117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "HOHETE",
        "middle_name": "YOHANNES",
        "name_prefix": "Dr.",
        "credential": "DMD;MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011079A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.