Jeffrey L Henken DDS

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

JEFFREY L HENKEN DDS

Practice address

1020 E Locust
Emmett, ID 83617

Phone

(208) 365-5064

Fax

(208) 365-4235

NPI assigned

Aug 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey L Henken, DDSNPI 1679683775

Title

Dentist Owner

Phone

(208) 365-5064

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey L Henken, DDS

  • Dentist
  • Emmett, ID
  • NPI 1679683775
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760592869",
    "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": {
        "organization_name": "JEFFREY L HENKEN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENKEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "208-365-5064",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "68726",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010012438",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho Dental Professionals, P.C. (Quail Run Dental Care)
• Idaho Priority Prescriptions
• Ikdo Emmett LLC
• Independent School District of Emmett #221
• Lisa Isaksen, NP-C, PMHNP-BC
• Juliette Jennings
• Logan Johnson, LMSW
• Jonathan Barrus DO PC (Gem Family Medicine)
• Hailey Lucile Kahre
• Christopher Kimball, OD

• 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 Aug 22, 2020; 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.