Individual provider Active NPI

Richard F Henry, DDS

  • General Practice Dentistry
  • Mt Sterling, KY
National Provider Identifier
1063580942
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6509 Issued in KY
Practice address
541 Willin Way
Mt Sterling, KY 40353-1495
Phone
(859) 498-1347
Fax
(859) 498-5722
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6509 KY Primary

Addresses

Primary practice location

541 Willin Way
Mt Sterling, KY 40353-1495

Mailing address

541 Willin Way
Mt Sterling, KY 40353-1495
Phone (859) 498-1347

Other identifiers 2

IdentifierTypeStateIssuer
600611OtherKYUNITED CONCORDIA OF PA
60065091MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20140218000347 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2365671351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1063580942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 WILLIN WAY",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531495",
            "telephone_number": "859-498-1347",
            "fax_number": "859-498-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 WILLIN WAY",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531495",
            "telephone_number": "859-498-1347",
            "fax_number": "859-498-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "RICHARD",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA OF PA",
            "identifier": "600611",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60065091",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

Verify at the official NPI Registry.