Robert L. Henderson, D.M.D PSC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ROBERT L. HENDERSON, D.M.D PSC

Practice address

903 Main St
West Liberty, KY 41472-1023

Phone

(606) 743-7480

Fax

(606) 743-7481

NPI assigned

Jun 25, 2008

Last updated

Aug 25, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

ROBERT L. HENDERSON, D.M.D, PSCAs reported in NPPES

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

Authorized official

Name

Mr. Robert L Henderson

Title

Office Manager

Phone

(606) 743-7480

Specialties & licenses 1

Addresses

Part of

Robert L Henderson DMD PSC

Locations

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1073775771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 MAIN ST",
            "city": "WEST LIBERTY",
            "state": "KY",
            "postal_code": "414721023",
            "telephone_number": "606-743-7480",
            "fax_number": "606-743-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MAIN ST",
            "city": "WEST LIBERTY",
            "state": "KY",
            "postal_code": "414721023",
            "telephone_number": "606-743-7480",
            "fax_number": "606-743-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L. HENDERSON, D.M.D PSC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROBERT L. HENDERSON, D.M.D, PSC",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-743-7480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Powell
• Provision Home
• Candice Ratliff
• Shateka Ratliff
• Stacy Lynn Ritchie, PT
• Tara Rohr
• Jimalee Yvonne Ross, L.C.S.W.
• Corey Ruffing
• Valerie Shepherd
• Kayla Sizemore

• Dental Clinic/Center in West Liberty, KY
• Providers in West Liberty, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.