Mike R Henrickson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11920 Issued in MN

Practice address

1560 Beam Ave
Suite 2
Maplewood, MN 55109-1191

Phone

(651) 777-8900

Fax

(651) 777-8908

NPI assigned

Apr 11, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Michael Henrickson DDS

  • Dental Clinic/Center
  • Maplewood, MN
  • NPI 1861054090
  NPD Authorized official
• Michael Henrickson DDS

  • Dental Clinic/Center
  • Burnsville, MN
  • NPI 1992571293
  NPD Authorized official
• Myron Henrickson, DDS PA

  • Dentist
  • Maplewood, MN
  • NPI 1740444827
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629291380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 BEAM AVE",
            "address_2": "SUITE 2",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091191",
            "telephone_number": "651-777-8900",
            "fax_number": "651-777-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 BEAM AVE",
            "address_2": "SUITE 2",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091191",
            "telephone_number": "651-777-8900",
            "fax_number": "651-777-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICKSON",
        "first_name": "MIKE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Heille
• Jacob Lee Helmer, MD
• Help Home Care, LLC
• Caitlin Stebbins Hemmerich
• Laura Hemstad, DPT
• Jennifer Henry, RN
• Gabrielle Kennedy Henshue, PA-C
• Soua Her-Xiong
• SE Thao Her
• Shoua Her, LSW

• General Practice Dentistry in Maplewood, MN
• Providers in Maplewood, MN by specialty
• General Practice Dentistry in Minnesota

• 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.