Active NPI
Matthew B Hendrickson, DDS
- General Practice Dentistry
- Denison, TX
National Provider Identifier
1205844628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 20486
- Practice address
- 2415 S Austin Ave
Ste 101
Denison, TX 75020-7741 - Phone
- (903) 327-8540
- NPI assigned
- Aug 3, 2006
- 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 | 20486 | TX | Primary |
Addresses
Primary practice location
2415 S Austin Ave
Ste 101
Denison, TX 75020-7741
Mailing address
2415 S Austin Ave
Ste 101
Denison, TX 75020-7741
Phone (903) 327-8540
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 |
|---|---|---|---|
| 20486 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirby Joe Robinson of Texas, DDS, P.C. | Past | Accepting new patients | |
| Affordable Dentures & Implants - Texas, PLLC | General Practice | Past | 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.
-
- General Practice Dentistry
- Denison, TX
- NPI 1346497526
-
dba Dentures and Dental Services
- Dentist
- Denison, TX
- NPI 1417973975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231977600000",
"number": "1205844628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 S AUSTIN AVE",
"address_2": "STE 101",
"city": "DENISON",
"state": "TX",
"postal_code": "750207741",
"telephone_number": "903-327-8540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 S AUSTIN AVE",
"address_2": "STE 101",
"city": "DENISON",
"state": "TX",
"postal_code": "750207741",
"telephone_number": "903-327-8540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKSON",
"first_name": "MATTHEW",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2009-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "20486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.