Paul J Henningson DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

D11047 Issued in MN

Legal business name

PAUL J HENNINGSON DDS PA

Practice address

501 Maple Street
Brainerd, MN 56401-3527

Phone

(218) 829-9403

NPI assigned

Mar 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul John Henningson, DDS

Title

President

Phone

(218) 829-9403

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285602664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MAPLE STREET",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013527",
            "telephone_number": "218-829-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MAPLE STREET",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013527",
            "telephone_number": "218-829-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL J HENNINGSON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENNINGSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-829-9403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Dentist in Minnesota

• 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.