Ivan K. Hendricksond.D.S.,Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3043 Issued in UT

Legal business name

IVAN K. HENDRICKSOND.D.S.,INC

Practice address

720 S River Rd Ste B210
St George, UT 84790-5584

Phone

(435) 656-0507

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ivan K Hendrickson, DDS

Title

Dentist

Phone

(435) 656-0507

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528092913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S RIVER RD STE B210",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847905584",
            "telephone_number": "435-656-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S RIVER RD STE B210",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847905584",
            "telephone_number": "435-656-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN K. HENDRICKSOND.D.S.,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "435-656-0507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "3043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isat
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• Ashley Isham
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• General Practice Dentistry in St George, UT
• Providers in St George, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.