Active NPI
David R Hennington, DDS
- General Practice Dentistry
- Georgetown, TX
National Provider Identifier
1114921574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15326
- Practice address
- 2425 Williams Dr
Ste E
Georgetown, TX 78628-3201 - Phone
- (512) 863-6888
- Fax
- (512) 869-8934
- NPI assigned
- Jun 13, 2005
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15326 | TX | Primary |
Addresses
Primary practice location
2425 Williams Dr
Ste E
Georgetown, TX 78628-3201
Mailing address
2425 Williams Dr
Ste E
Georgetown, TX 78628-3201
Phone (512) 863-6888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 2, 2017 through Jan 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15326 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114921574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 WILLIAMS DR",
"address_2": "STE E",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786283201",
"telephone_number": "512-863-6888",
"fax_number": "512-869-8934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 WILLIAMS DR",
"address_2": "STE E",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786283201",
"telephone_number": "512-863-6888",
"fax_number": "512-869-8934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNINGTON",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "15326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.