Individual provider Active NPI

Brett Houston Henderson, D.M.D., M.S.D.

  • Pediatric Dentistry
  • Hendersonville, TN
National Provider Identifier
1164894044
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10288 Issued in TN
Practice address
410 N Parrish PL Ste 1000
Hendersonville, TN 37075-1003
Phone
(615) 824-1700
NPI assigned
Oct 30, 2015
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1316 OK
Dentist 122300000X 10288 TN
Pediatric Dentistry 1223P0221X 10288 TN Primary

Addresses

Primary practice location

410 N Parrish PL Ste 1000
Hendersonville, TN 37075-1003

Mailing address

410 N Parrish PL Ste 1000
Hendersonville, TN 37075-1003
Phone (615) 824-1700

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
10288TNMDSocial Worker
1316OKMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1164894044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N PARRISH PL STE 1000",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370751003",
            "telephone_number": "615-824-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N PARRISH PL STE 1000",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370751003",
            "telephone_number": "615-824-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BRETT",
        "middle_name": "HOUSTON",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-30",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "1316",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10288",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "10288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.

Verify at the official NPI Registry.