Philip E Henderlight Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

KY5414 Issued in KY

Practice address

1507 S Main St
Corbin, KY 40701-1932

Phone

(606) 523-1110

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508996240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S MAIN ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011932",
            "telephone_number": "606-523-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S MAIN ST",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407011932",
            "telephone_number": "606-523-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERLIGHT",
        "first_name": "PHILIP",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "KY5414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60054145",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Gentry Helton, APRN
• Gwendolyn Ann Helton, BS, PE
• Kesia Helton
• Thanh N Helton, M.ED
• Krystle Danielle Hembree, MA
• Angel Henderson, APRN
• Henrietta Hendrickson, RN
• Juanita Hendrickson
• Kayla Hendrickson, APRN
• Kelsi Marie Hendrickson

• General Practice Dentistry in Corbin, KY
• Providers in Corbin, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.