Brett A Henrikson, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12010155A Issued in IN

Practice address

2 Executive Dr Ste a
Lafayette, IN 47905-4859

Phone

(765) 807-0230

Fax

(765) 807-0234

NPI assigned

May 17, 2007

Last updated

Feb 24, 2011By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crawfordsville Oral Surgery

  • Dental Clinic/Center
  • Crawfordsville, IN
  • NPI 1053617746
  Authorized official Same address or phone
• Lafayette Oral and Maxillofacial Surgery Group, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lafayette, IN
  • NPI 1972685238
  Authorized official Same address or phone

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1063629988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EXECUTIVE DR STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054859",
            "telephone_number": "765-807-0230",
            "fax_number": "765-807-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EXECUTIVE DR STE A",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054859",
            "telephone_number": "765-807-0230",
            "fax_number": "765-807-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIKSON",
        "first_name": "BRETT",
        "middle_name": "A",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12010155A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200471200",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Henderzahs, DDS, MSD
• Cheyanne Hendren
• Hillary Hendrick
• Jason Paul Hendrick, MD
• Kristin Nicole Henrich, PHARMD
• Brian Thomas Henry, DDS
• Lesha Henry, CST
• Mary Henry, CST
• Stephen Henson, MD
• Michelle B Herberts, MD

• Oral and Maxillofacial Surgery (Dentist) in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.