Jerick William Hensen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2223 Issued in ND

Practice address

1300 37TH Ave SW
Minot, ND 58701-7240

Phone

(701) 852-5595

Fax

(701) 852-2669

NPI assigned

Jun 17, 2014

Last updated

Jun 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Souris Valley Dental Group

  • General Practice Dentistry
  • Minot, ND
  • NPI 1861497430
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1255745378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017240",
            "telephone_number": "701-852-5595",
            "fax_number": "701-852-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017240",
            "telephone_number": "701-852-5595",
            "fax_number": "701-852-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSEN",
        "first_name": "JERICK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41311",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Halle Michelle Hendrickson, FNP
• Robert D Heninger, MD
• Jennifer K Henjum, CRNA
• Tanya Marie Hennix
• Denise M Henry
• Jaydin A Hepper
• David A Herfendal, D.D.S.
• Aaron Christopher Herington, MD
• Kristen Hernandez, M OTR/L
• Heroic Path Counseling PLLC

• General Practice Dentistry in Minot, ND
• Providers in Minot, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.