Individual provider Active NPI

David R Hendrick, DDS

  • Dentist
  • Shelby, NC
National Provider Identifier
1124032628
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
NC6442 Issued in NC
Practice address
613 McBrayer Homestead Rd
Shelby, NC 28152-9536
Phone
(704) 434-4876
Fax
(704) 434-4878
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NC6442 NC Primary

Addresses

Primary practice location

613 McBrayer Homestead Rd
Shelby, NC 28152-9536

Mailing address

613 McBrayer Homestead Rd
Shelby, NC 28152-9536
Phone (704) 434-4876

Other identifiers 1

IdentifierTypeStateIssuer
8993801MedicaidNC

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

LicenseStateTypeSpecialty
NC6442NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
David R Hendrick DDS PA Past Accepting new patients
Benjamin Caple DDS, PLLC PastSince Mar 11, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1124032628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 MCBRAYER HOMESTEAD RD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281529536",
            "telephone_number": "704-434-4876",
            "fax_number": "704-434-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 MCBRAYER HOMESTEAD RD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281529536",
            "telephone_number": "704-434-4876",
            "fax_number": "704-434-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "NC6442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8993801",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.