Theodore B Hennig, DDS MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901014716 Issued in MI

Practice address

4350 Fashion Square Boulevard
Saginaw, MI 48603-1249

Phone

(989) 799-7128

Fax

(989) 799-3895

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417023144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 FASHION SQUARE BOULEVARD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031249",
            "telephone_number": "989-799-7128",
            "fax_number": "989-799-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 FASHION SQUARE BOULEVARD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031249",
            "telephone_number": "989-799-7128",
            "fax_number": "989-799-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNIG",
        "first_name": "THEODORE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901014716",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901014716",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "OG361000",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "OG361000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Henne, OTRL
• Marcia Henne
• Shannon Margaret Hennessy
• Hennig Woodbury & Howard PC
• Kevin Hennig
• Lindsay Rose Henning
• Rachael Lynn Henning
• Sarah Nicole Henninger, LMSW
• Jason Michael Henry, P.T.
• Tracey Deane Henson, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.