Individual provider Active NPI

Jessica Henrick, RDH

  • Dental Hygienist
  • New Haven, CT
National Provider Identifier
1063958502
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
7843 Issued in CT
Practice address
54 Meadow St
New Haven Public Schools
New Haven, CT 06519-1783
Phone
(203) 946-4860
NPI assigned
Jan 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 7843 CT Primary

Addresses

Primary practice location

54 Meadow St
New Haven Public Schools
New Haven, CT 06519-1783

Mailing address

18 Mills Dr
West Haven, CT 06516-6250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1063958502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MILLS DR",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065166250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MEADOW ST",
            "address_2": "NEW HAVEN PUBLIC SCHOOLS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191783",
            "telephone_number": "203-946-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICK",
        "first_name": "JESSICA",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "7843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.