L. M. Henderson D.M.D.,P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2209 Issued in AR

Legal business name

L. M. HENDERSON D.M.D.,P.A.

Practice address

3006 E Kiehl Ave
Sherwood, AR 72120-3228

Phone

(501) 835-0444

Fax

(501) 835-8730

NPI assigned

Jan 28, 2008

Organization subpart

No

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

Authorized official

Name

Larry M Henderson, D.M.D.,P.A.

Title

Dentist

Phone

(501) 835-0444

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1467639872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203228",
            "telephone_number": "501-835-0444",
            "fax_number": "501-835-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203228",
            "telephone_number": "501-835-0444",
            "fax_number": "501-835-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L. M. HENDERSON D.M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "501-835-0444",
        "authorized_official_credential": "D.M.D.,P.A."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5C125",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Marie Komarek, ATC
• Macy Rebekah Kottler, PHARMD
• Ali Krisht, MD
• Khaled M Krisht
• Mami Kuwano, BT
• Katelyn Elizabeth Lacy, OTD
• Candace B Ladisky
• Lakeview Senior Care
• Marrissa K Lamb
• Mary Ellen Lamb, P.D.

• General Practice Dentistry in Sherwood, AR
• Providers in Sherwood, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.