Molly Anne Henry, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12676 Issued in MN

Practice address

1965 Cliff Lake Rd
Suite #102
Eagan, MN 55122-2590

Phone

(651) 452-4828

Fax

(651) 452-4856

NPI assigned

Jun 16, 2009

Last updated

Jun 16, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Northland Dental Partners, PLLC

  dba Metro Dentalcare Eagan

  • General Practice Dentistry
  • Eagan, MN
  • NPI 1619625043
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1225265309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16375 CRYSTAL HILLS CIR",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445820",
            "telephone_number": "612-599-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 CLIFF LAKE RD",
            "address_2": "SUITE #102",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222590",
            "telephone_number": "651-452-4828",
            "fax_number": "651-452-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MOLLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helping Others Home Healthcare
• John Hemingson, DC
• Ken L Henjum, RPH
• Thomas James Olson Henke
• Chelsey A Henney, D.C.
• Jchuechu Hmong Her
• Amy Herbranson, PHARMD
• Ashlee Herget
• Heritage Home Health Care LLC
• Mary Elizabeth Hernandez Petrulo

• General Practice Dentistry in Eagan, MN
• Providers in Eagan, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.