Active NPI
Don-Michael Hendricks, D.M.D.
- Dentist
- Lexington, KY
National Provider Identifier
1083876247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8624
- Practice address
- 1025 Dove Run Rd
Suite 208
Lexington, KY 40502-3588 - Phone
- (859) 368-8618
- Fax
- (859) 368-8648
- NPI assigned
- Jun 30, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8624 | KY | |
| Dentist | 122300000X | 8624 | KY | Primary |
Addresses
Primary practice location
1025 Dove Run Rd
Suite 208
Lexington, KY 40502-3588
Mailing address
1025 Dove Run Rd
Suite 208
Lexington, KY 40502-3588
Phone (859) 368-8618
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100070750 | Medicaid | KY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8624 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hendricks Family & Cosmetic Dentistry | Past | Accepting new patients | |
| Hendricks Family & Cosmetic Dentistry | General Practice | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Lexington, KY
- NPI 1497029201
-
- Point of Service
- Lexington, KY
- NPI 1790175438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699488000000",
"number": "1083876247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 DOVE RUN RD",
"address_2": "SUITE 208",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405023588",
"telephone_number": "859-368-8618",
"fax_number": "859-368-8648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 DOVE RUN RD",
"address_2": "SUITE 208",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405023588",
"telephone_number": "859-368-8618",
"fax_number": "859-368-8648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "DON-MICHAEL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-30",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "8624",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "8624",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100070750",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.