Active NPI
Bryan Neal Henderson II, DDS
- Dental Anesthesiology
- Dallas, TX
National Provider Identifier
1114050002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- 15565
- Practice address
- 8325 Walnut Hill LN Ste 235
Dallas, TX 75231-4255 - Phone
- (214) 265-7391
- Fax
- (214) 265-7392
- NPI assigned
- Mar 13, 2007
- 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 |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | 15565 | TX | Primary |
Addresses
Primary practice location
8325 Walnut Hill LN Ste 235
Dallas, TX 75231-4255
Mailing address
8325 Walnut Hill LN Ste 235
Dallas, TX 75231-4255
Phone (214) 265-7391
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 |
|---|---|---|---|
| 15565 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1114050002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8325 WALNUT HILL LN STE 235",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314255",
"telephone_number": "214-265-7391",
"fax_number": "214-265-7392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8325 WALNUT HILL LN STE 235",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314255",
"telephone_number": "214-265-7391",
"fax_number": "214-265-7392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "BRYAN",
"middle_name": "NEAL",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "TX",
"license": "15565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.