Jeffrey L Henken, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D1830 Issued in ID

Practice address

1020 E Locust
Emmett, ID 83617

Phone

(208) 365-5064

Fax

(208) 365-4235

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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.

• Jeffrey L Henken DDS

  • Dentist
  • Emmett, ID
  • NPI 1760592869
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679683775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 E LOCUST",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "83617",
            "telephone_number": "208-365-5064",
            "fax_number": "208-365-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E LOCUST",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "83617",
            "telephone_number": "208-365-5064",
            "fax_number": "208-365-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKEN",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D1830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010012438",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "68726",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gretchen Kletzer Hancock
• Amanda Dawn Hardisty, CPHT
• Brigham Hardy, DO
• Cody A Harrison, LMT
• Healing Through Horses, Inc.
• Patricia Lynn Hennequin, RN, BSN, IBCLC
• Jo Anna Henson1
• Bryan Hewett, HIS
• Hines Orthopedics and Sports Medicine, PLLC
• Jerod L Hines, M.D.

• Dentist in Emmett, ID
• Providers in Emmett, ID by specialty
• Dentist 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.
• 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.