Individual provider Active NPI

Gail Lauren Henry, D.D.S.

  • Dentist
  • Mansfield, OH
National Provider Identifier
1659616779
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-023857 Issued in OH
Practice address
1041 Cricket LN
Mansfield, OH 44906-4105
Phone
(419) 526-4249
NPI assigned
Nov 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-023857 OH Primary

Addresses

Primary practice location

1041 Cricket LN
Mansfield, OH 44906-4105

Mailing address

1041 Cricket LN
Mansfield, OH 44906-4105
Phone (419) 526-4249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221010000780 IL Practitioner - DentistPractitioner - Sleep Medicine 8820474224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Sleep Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sigma Health PCGroup PAC ID 2961305693, 22 clinicians

Practice addresses (Care Compare)

900 Technology Way
Suite 120
Libertyville, IL 60048-5364
Phone (708) 364-0261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023857OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sigma Health PC CurrentSince Jun 3, 2022 Accepting new patients
Douglas E. Beilstein,D.D.S, Dentist Past Accepting new patients
David Henry DDS and Randell Roark DDS Inc. Past Accepting new patients

Locations

680 N Lake Shore Dr
Ste 1210
Chicago, IL 60611
Phone (312) 587-3765

2501 Compass Rd
Ste 105
Glenview, IL 60026
Phone (847) 535-6900

900 Technology Way
Ste 120
Libertyville, IL 60048
Phone (708) 364-0269

900 Technology Way
#120
Libertyville, IL 60048
Phone (847) 231-4507

10640 165th St
Orland Park, IL 60467

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1659616779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 CRICKET LN",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449064105",
            "telephone_number": "419-526-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 CRICKET LN",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449064105",
            "telephone_number": "419-526-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "GAIL",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-023857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.