Active NPI
James Joseph Henderson III, DMD, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Furlong, PA
National Provider Identifier
1073205977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS043132
- Practice address
- 3503 York Rd Ste 5
Furlong, PA 18925-1175 - Phone
- (215) 622-1386
- NPI assigned
- May 22, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS043132 | PA | Primary |
Addresses
Primary practice location
3503 York Rd Ste 5
Furlong, PA 18925-1175
Mailing address
1414 Christian Street
Apt 3 Rear
Philadelphia, PA 19146
Phone (215) 622-1386
Other practice location 1
1819 S Broad St
Philadelphia, PA 19148-2156
Phone (215) 622-1386
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS043132 | PA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1073205977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 CHRISTIAN STREET",
"address_2": "APT 3 REAR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19146",
"telephone_number": "215-622-1386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3503 YORK RD STE 5",
"city": "FURLONG",
"state": "PA",
"postal_code": "189251175",
"telephone_number": "215-622-1386"
}
],
"practiceLocations": [
{
"address_1": "1819 S Broad St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191482156",
"country_code": "US",
"telephone_number": "215-622-1386",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENDERSON",
"first_name": "JAMES",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DMD, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PA",
"license": "DS043132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Furlong, PA
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- Shilpa Jobanputra, DMD
- Laura Maureen Johnson, PT
- Rhegan Paige Johnson
- Yan Kiriakov, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.