Active NPI
Robert S Henshaw, DDS
- Periodontics
- Portland, OR
National Provider Identifier
1699824151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D7714
- Practice address
- 11786 SW Barnes Rd
Suite 210
Portland, OR 97225-5925 - Phone
- (503) 531-3550
- Fax
- (503) 531-3560
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | D7714 | OR | Primary |
Addresses
Primary practice location
11786 SW Barnes Rd
Suite 210
Portland, OR 97225-5925
Mailing address
11786 SW Barnes Rd
Suite 210
Portland, OR 97225-5925
Phone (503) 531-3550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7714 | OR | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699824151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11786 SW BARNES RD",
"address_2": "SUITE 210",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255925",
"telephone_number": "503-531-3550",
"fax_number": "503-531-3560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11786 SW BARNES RD",
"address_2": "SUITE 210",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255925",
"telephone_number": "503-531-3550",
"fax_number": "503-531-3560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENSHAW",
"first_name": "ROBERT",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "OR",
"license": "D7714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- 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.