Katherine Anne Henderson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.032249 Issued in IL

Practice address

1600 S 4TH Ave Ste 110
Morton, IL 61550-3401

Phone

(309) 263-2781

NPI assigned

Jul 18, 2019

Last updated

Jun 7, 2022By the provider in NPPES

Sex

Female

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smalltown Dental Tremont

  • Dental Clinic/Center
  • Tremont, IL
  • NPI 1770046088
  NPD (past)

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1861045924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615503401",
            "telephone_number": "309-263-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 4TH AVE STE 110",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615503401",
            "telephone_number": "309-263-2781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 S James St",
            "address_purpose": "LOCATION",
            "city": "Tremont",
            "state": "IL",
            "postal_code": "615688048",
            "country_code": "US",
            "telephone_number": "309-925-7851",
            "fax_number": "309-925-2022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthy Spines Healthy Minds
• Heartland Chiropractic Clinic of Morton
• Sarah Elaine Heinz, APRN
• Beth Helmold, MS, RD, CSP, LDN
• Helping Hands Home Healthcare and Staffing Agency, LLC (Elysian Hospice)
• Emily Anne Hendrix
• Sarah Nicole Herron, FNP
• Highland Park CVS, L.L.C. (CVS Pharmacy #06452)
• Lori Hirst, LCPC
• Hobson & Company Inc (Home Instead)

• General Practice Dentistry in Morton, IL
• Providers in Morton, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.