Tarem Eric Hendricks, DMD

Individual provider Active NPI General Practice Dentistry · Warner Robins, GA

NPI 1093882136 · NPPES record last updated Jan 26, 2024

Key facts

NPI
1093882136
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN012345 (GA)
Practice address
98 Cohen Walker Dr
Warner Robins, GA 31088-0744
Phone
(478) 218-2000
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 12

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN012345GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Colton Dental Group Past Accepting new patients
Baldwin County Health Department Past
since Jun 5, 2022
Accepting new patients
Jones County Health Department Past
since Oct 10, 2021
Accepting new patients
Houston County Health Department Past Accepting new patients
Crawford County Health Department Past
since Oct 10, 2021
Accepting new patients
County of Hancock Health Department Past
since Oct 10, 2021
Accepting new patients
County of Monroe Health Department Past
since Oct 10, 2021
Accepting new patients
Putnam County Board of Health Past
since Oct 1, 2021
Accepting new patients
Macon-Bibb County Health Department Past Accepting new patients
Washington County Board of Health Past
since Oct 10, 2021
Accepting new patients
Peach County Board of Health Past
since Jun 5, 2022
Accepting new patients
County of Jasper Health Department Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012345 GA Yes

Addresses

Primary practice location

98 Cohen Walker Dr
Warner Robins, GA 31088-0744

Mailing address

98 Cohen Walker Dr
Warner Robins, GA 31088-0744
Phone (478) 218-2000

Other practice location 1

655 7th St
Warner Robins, GA 31098-2227
Phone (478) 327-8487

Other identifiers

IdentifierTypeStateIssuer
000982121BMedicaidGA

Other providers in Warner Robins, GA

All providers in Warner Robins, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.