NPIMap

Organization Active NPI

Brian L Henningsen DDS PC

  • Dentist
  • Jefferson City, MO
National Provider Identifier
1215099437
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
013482 Issued in MO
Legal business name
BRIAN L HENNINGSEN DDS PC
Practice address
1600 Southwest Blvd # B
Jefferson City, MO 65109-2434
Phone
(573) 635-4852
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brian L Henningsen, D.D.S.NPI 1033158993
Title
Owner
Phone
(573) 635-4852

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 013482 MO Primary

Addresses

Primary practice location

1600 Southwest Blvd # B
Jefferson City, MO 65109-2434

Mailing address

1600 Southwest Blvd # B
Jefferson City, MO 65109-2434
Phone (573) 635-4852

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215099437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SOUTHWEST BLVD # B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092434",
            "telephone_number": "573-635-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SOUTHWEST BLVD # B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092434",
            "telephone_number": "573-635-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN L HENNINGSEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENNINGSEN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-635-4852",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "013482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.