John R Hendricks Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9271 Issued in SC

Practice address

70 Pennington Dr Ste 7
Bluffton, SC 29910-6056

Phone

(843) 706-3377

Fax

(843) 706-3381

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• John Hendricks DDS LLC

  • Dental Clinic/Center
  • Bluffton, SC
  • NPI 1992269245
  NPD Authorized official
• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1093411910
  NPD (past)
• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1376929125
  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": "1548633600000",
    "number": "1669695045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE RD",
            "address_2": "SUITE 202",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978456",
            "telephone_number": "770-813-0079",
            "fax_number": "770-814-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PENNINGTON DR STE 7",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106056",
            "telephone_number": "843-706-3377",
            "fax_number": "843-706-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "010491",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SEPERATE TAX ID #",
            "identifier": "582014496",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Health Performance Systems LLC
• Healthfair Plus SC PC
• Heart Associate of Hilton Head PC
• Janis A. Hedin, MD
• Kathleen Brikmann Hefferon, PA
• Karen M Henrichsen, D.O.
• Heritage Dental Spa and Salon
• Heritage Dermatology PC
• Chrysmaris Hernandez
• Morgan Leigh Herrington, DMD

• General Practice Dentistry in Bluffton, SC
• Providers in Bluffton, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.