Bradley J Henkenius, DDS, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRADLEY J HENKENIUS, DDS, PC

Doing business as

Village Dental Care

Practice address

710 N Beaver St BLDG 1
Flagstaff, AZ 86001-3100

Phone

(928) 774-0181

Fax

(928) 774-7510

NPI assigned

Oct 30, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Bradley J Henkenius, DDSNPI 1134293632

Title

Owner/President

Phone

(928) 774-0181

Specialties & licenses 1

Addresses

Other names 1

• Village Dental Care Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley Joseph Henkenius, DDS

  • General Practice Dentistry
  • Flagstaff, AZ
  • NPI 1134293632
  NPD (past) Authorized official
• Kurt Geisel, DDS

  • Dentist
  • Phoenix, AZ
  • NPI 1497167134
  NPD (past)

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1548737208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N BEAVER ST BLDG 1",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013100",
            "telephone_number": "928-774-0181",
            "fax_number": "928-774-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N BEAVER ST BLDG 1",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013100",
            "telephone_number": "928-774-0181",
            "fax_number": "928-774-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY J HENKENIUS, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "HENKENIUS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "928-774-0181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Kathleen Boyle, M.D.
• Randi Braak, PHARMD
• Linda L Brabant, P.T.
• Braden Partners LP
• Landon Hope Bradford, ATC
• Avery Brain, R.N.
• Peter Gilbert Brainard, CRNA
• Krista Michelle Morgan Branch, PT
• Patricia Brandon, D.C.
• Ted A. Branstetter, PA-C

• Dental Clinic/Center in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.