Henderson & Associates DDS PC Dba Jolly Smiles Mobile Dental Services

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HENDERSON & ASSOCIATES DDS PC DBA JOLLY SMILES MOBILE DENTAL SERVICES

Doing business as

Jolly Smiles Dental

Practice address

645 Griswold St Ste 224
Detroit, MI 48226-4014

Phone

(586) 873-1014

NPI assigned

Jan 10, 2022

Organization subpart

No

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

Authorized official

Name

Elbert M. Henderson, DDS

Title

Director

Phone

(586) 873-1014

Specialties & licenses 1

Addresses

Other names 1

• Jolly Smiles Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katie Jordan, RDH

  • Dental Hygienist
  • Lathrup Village, MI
  • NPI 1033686464
  NPD (past)

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654300800000",
    "number": "1770244972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 GRISWOLD ST STE 224",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264014",
            "telephone_number": "586-873-1014",
            "fax_number": "248-864-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 GRISWOLD ST STE 224",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264014",
            "telephone_number": "586-873-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON & ASSOCIATES DDS PC DBA JOLLY SMILES MOBILE DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ELBERT",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-873-1014",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jolly Smiles Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jolly Smiles Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pekisha Lee Hemlinger, LLPC
• Laura Marie Hempel, RN
• Alyssia Chantel Hence
• Justine Hence
• Kahdima Hence
• Jeneane L Henderson-Shields
• Alisha Henderson
• Andrea Henderson
• Andrew Todd Henderson, LPC
• Carrie Ann Henderson, M.S. CCC-SLP

• Dental Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; 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.