Individual provider Active NPI

Jennifer Lynn Henkin, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Selden, NY
National Provider Identifier
1083874333
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
056544 Issued in NY
Practice address
805 Middle Country Rd
Selden, NY 11784-2504
Phone
(631) 732-0233
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 056544 NY Primary

Addresses

Primary practice location

805 Middle Country Rd
Selden, NY 11784-2504

Mailing address

330 E 38TH St Apt 54D
New York, NY 10016-9804
Phone (305) 409-7369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140219000933 NY Practitioner - Oral Surgery 7315176294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Exceldent Dental of Brookhaven LLP PastSince May 22, 2022 Accepting new patients
Norman Gross DDS Barry Wilder DDS PC PastSince May 22, 2022 Accepting new patients

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1083874333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E 38TH ST APT 54D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169804",
            "telephone_number": "305-409-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MIDDLE COUNTRY RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117842504",
            "telephone_number": "631-732-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKIN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "056544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selden, NY

Sources for this page

Verify at the official NPI Registry.