Kevin Charles Henry, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3597 Issued in ID

Practice address

7800 Ustick
Boise, ID 83704-5848

Phone

(208) 375-0572

Fax

(208) 375-1658

NPI assigned

Mar 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578694170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 USTICK RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045848",
            "telephone_number": "208-375-0572",
            "fax_number": "208-375-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 USTICK",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045848",
            "telephone_number": "208-375-0572",
            "fax_number": "208-375-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KEVIN",
        "middle_name": "CHARLES",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Ellen Henkel, L.M.T.
• Lauren McMorrow Henken
• Aimee Henley
• Travis Henman, PA-C
• Linda M. Henrikson, COTA L
• Matthew Alan Henslee, COTA
• Dakota Hensley, PA
• Kaylee Lane Henson, LMT
• Madison M Henson
• Melanie Henstrom, IBCLC

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.