Robert Paul Hendricksen, DDS MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30015680 Issued in OH

Practice address

7265 Far Hills Ave
Centerville, OH 45459-4206

Phone

(937) 435-4924

Fax

(937) 435-6447

NPI assigned

Aug 29, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1689783334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7265 FAR HILLS AVE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594206",
            "telephone_number": "937-435-4924",
            "fax_number": "937-435-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7265 FAR HILLS AVE",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594206",
            "telephone_number": "937-435-4924",
            "fax_number": "937-435-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSEN",
        "first_name": "ROBERT",
        "middle_name": "PAUL",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30015680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava Catherine Hein
• Kyla Helmuth
• Sara Beth Helton, COTA/L
• Bailey Henderlong, AUD
• Emily Caroline Henderschedt, FNP-C
• Anthony Hensley
• Michael A Herbenick, MD
• Douglas Herdman
• Azure D Herrington, RN
• Nathan R Hershberger, DPT

• Oral and Maxillofacial Surgery (Dentist) in Centerville, OH
• Providers in Centerville, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.