NPIMap

Organization Active NPI

Hendricks Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Brownsburg, IN
National Provider Identifier
1265074710
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
HENDRICKS PEDIATRIC DENTISTRY, LLC
Practice address
1557 Windview
Brownsburg, IN 46112-7641
Phone
(502) 314-3330
NPI assigned
Oct 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Authorized official

Name
Andrea SheltonNPI 1194160267
Title
Dentist
Phone
(502) 314-3330

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1557 Windview
Brownsburg, IN 46112-7641

Mailing address

1557 Windview
Brownsburg, IN 46112-7641

Other identifiers 3

IdentifierTypeStateIssuer
12012911AOtherININ DENTAL LICENSE
1194160267OtherNPI TYPE 1
201375550MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL andreachadwickdental@gmail.com

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": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1265074710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1557 WINDVIEW",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 WINDVIEW",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461127641",
            "telephone_number": "502-314-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICKS PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "502-314-3330"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN DENTAL LICENSE",
            "identifier": "12012911A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1194160267",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201375550",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "andreachadwickdental@gmail.com",
            "affiliation": "N",
            "address_1": "1557 Windview",
            "city": "Brownsburg",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461127641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.