NPIMap

Organization Active NPI

Hensley Pediatric Dentistry, Inc.

  • Pediatric Dentistry
  • Dayton, OH
National Provider Identifier
1447496476
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
21855 Issued in OH
Legal business name
HENSLEY PEDIATRIC DENTISTRY, INC.
Doing business as
Dayton Pediatric Dentistry
Practice address
1010 Valley St Ste 113
Dayton, OH 45404-2070
Phone
(937) 641-3455
Fax
(937) 641-5448
NPI assigned
Dec 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Dr. Kyle Martin Hensley, D.D.S.
Title
President/Pediatric Dentist
Phone
(937) 641-3455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 21855 OH Primary

Addresses

Primary practice location

1010 Valley St Ste 113
Dayton, OH 45404-2070

Mailing address

1010 Valley St Ste 113
Dayton, OH 45404-2070
Phone (937) 641-3455

Other identifiers 1

IdentifierTypeStateIssuer
188168619MedicaidOH

Other names 1

  • Dayton Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1010 Valley St
Ste 113
Dayton, OH 45404
Phone (937) 641-3455

Practitioners & affiliated clinicians

Practitioners 3

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": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1447496476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 VALLEY ST STE 113",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042070",
            "telephone_number": "937-641-3455",
            "fax_number": "937-641-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 VALLEY ST STE 113",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454042070",
            "telephone_number": "937-641-3455",
            "fax_number": "937-641-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENSLEY PEDIATRIC DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "HENSLEY",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "937-641-3455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "21855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188168619",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dayton Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.