Jason D. Henderson, DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

054488 Issued in NY

Legal business name

JASON D. HENDERSON, DDS PC

Practice address

8179 Cazenovia Rd
Manlius, NY 13104-9778

Phone

(315) 685-2246

Fax

(315) 682-3914

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Jason D. Henderson, DDSNPI 1093987216

Title

Owner/ Dentist

Phone

(315) 682-2466

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 4

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

• Jason David Henderson, DDS

  • General Practice Dentistry
  • Manlius, NY
  • NPI 1093987216
  NPD (past) Authorized official
• Stephanie Wells Hill, R.D.H.

  • Dental Hygienist
  • Manlius, NY
  • NPI 1215247499
  NPD (past)
• William Helf Karp, DDS

  • Dentist
  • Manlius, NY
  • NPI 1326118738
  NPD (past)
• Thomas Anthony Martin, DDS

  • General Practice Dentistry
  • Tonawanda, NY
  • NPI 1588820799
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1316096340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8179 CAZENOVIA RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049778",
            "telephone_number": "315-685-2246",
            "fax_number": "315-682-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8179 CAZENOVIA RD",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049778",
            "telephone_number": "315-685-2246",
            "fax_number": "315-682-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON D. HENDERSON, DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "315-682-2466",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "054488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03224320",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Immediate Medical Care of Cny, PC
• Indeed Wellness, LLC
• J. Christopher Stringer, MD PLLC
• Mary J Jackson, MD
• Sandra Renee Jackson, PT, DPT, CHT
• Jean Howard
• Susan Marjorie Jenner, NP
• Barbara Gwen Jones
• Julie Ann Kaiser, RN
• Philip Kaplan, MD

• Dentist in Manlius, NY
• Providers in Manlius, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.