Nathan P Henderson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

8658 Issued in TN

Practice address

5707 Highway 58 Ste 103
Harrison, TN 37341-9525

Phone

(423) 344-3884

Fax

(423) 344-7152

NPI assigned

May 30, 2007

Last updated

Oct 21, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Harrison Family Dentistry, PLLC

  • General Practice Dentistry
  • Harrison, TN
  • NPI 1639318496
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1629279385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 HIGHWAY 58 STE 103",
            "city": "HARRISON",
            "state": "TN",
            "postal_code": "373419525",
            "telephone_number": "423-344-3884",
            "fax_number": "423-344-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 HIGHWAY 58 STE 103",
            "city": "HARRISON",
            "state": "TN",
            "postal_code": "373419525",
            "telephone_number": "423-344-3884",
            "fax_number": "423-344-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "NATHAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "8658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fast Pace Medical Clinic PLLC
• Full Circle Behavior Consulting, LLC
• Theora Mae Fuson, DPH
• Ashley N Gibbs, PT
• Harrison Family Dentistry, PLLC
• Independent Physical Therapy LLC
• Initial Choice Transportation LLC
• Clara J Iuliano
• Rhonda Gale Johnson, PTA,ATC
• K VA T Food Stores Inc (Food City Pharmacy #717)

• Dentist in Harrison, TN
• Providers in Harrison, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.