Robert W Henderson, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7379 Issued in KY

Practice address

101 Darby Dr Ste 101
Georgetown, KY 40324-8715

Phone

(502) 863-5858

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Georgetown Oral and Facial Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Georgetown, KY
  • NPI 1609000272
  NPD (past)
• Kentucky Center for Oral & Maxillofacial Surgery PSC

  • Oral and Maxillofacial Surgery (Dentist)
  • Richmond, KY
  • NPI 1457379307
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1811915622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DARBY DR # 101",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248715",
            "telephone_number": "502-863-5858",
            "fax_number": "502-863-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DARBY DR STE 101",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248715",
            "telephone_number": "502-863-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7379",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "7379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1609000272",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healing Hands Inc
• Healthcore Family Practice, PLLC
• Healthy Hedgehog, PLLC
• Katherine Lynn Helly, LAT, ATC
• Jayden Henderson, LMT
• Brian Keith Hendrix, D.C.
• Taylor Henry, APRN
• Katherine Marie Henson, MA, CCC-SLP
• Merrisa Kennedy Heraldson, ATC
• Jana Hess, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.