Robin D Henderson, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0045 Issued in OK

Practice address

9112 N. May Ave,
Okla. City, OK 73120

Phone

(405) 947-0486

Fax

(405) 942-4392

NPI assigned

Feb 19, 2007

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

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.

Opted out of Medicare

Yes, effective May 10, 2016 through May 10, 2028

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Oklahoma Center for Implants and Periodontics

  • Dental Clinic/Center
  • Oklahoma City, OK
  • NPI 1609092642
  NPD (past) Authorized official

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1770627044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9112 N. MAY AVE,",
            "city": "OKLA. CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-947-0486",
            "fax_number": "405-942-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9112 N. MAY AVE,",
            "city": "OKLA. CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-947-0486",
            "fax_number": "405-942-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ROBIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OK",
            "license": "0045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Lea Armstrong, LCSW
• G Bolar Garrison MD Inc
• Anthony Vincent Guadagno, DC
• Lori Eldean Hansen, MD
• William Edward Holcomb, DDS
• Glen Conrad Hornbuckle, DDS MS FACD
• Chris A Hunt, DDS, MS
• Jeremiah A Jansen, MD
• Meridian Foot Clinic Inc

• Periodontics in Okla. City, OK
• Providers in Okla. City, OK by specialty
• Periodontics in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.