Active NPI
Newton H Henderson III, DDS
- General Practice Dentistry
- Glendale, AZ
National Provider Identifier
1154588069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0085835
- Practice address
- 20359 N 59TH Ave
Suite 101
Glendale, AZ 85308-6856 - Phone
- (623) 376-9400
- NPI assigned
- May 19, 2008
- Last updated
- Jan 11, 2017
- Sex
- Male
- Sole proprietor
- No
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 | 0085835 | AZ | Primary |
Addresses
Primary practice location
20359 N 59TH Ave
Suite 101
Glendale, AZ 85308-6856
Mailing address
PO Box 860036
Minneapolis, MN 55486-0036
Phone (623) 376-9400
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 |
|---|---|---|---|
| 0085835 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DCP Az, LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1154588069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 860036",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554860036",
"telephone_number": "623-376-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20359 N 59TH AVE",
"address_2": "SUITE 101",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086856",
"telephone_number": "623-376-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "NEWTON",
"middle_name": "H",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "0085835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.