Jason Henderson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5223-015 Issued in WI

Practice address

1380 S Commercial St
Neenah, WI 54956-4636

Phone

(920) 725-5357

Fax

(920) 969-9813

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in WI

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.

• Florek Henderson Dental LLC

  • General Practice Dentistry
  • Neenah, WI
  • NPI 1225127947
  NPD (past) Authorized official

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871699900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564636",
            "telephone_number": "920-725-5357",
            "fax_number": "920-969-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564636",
            "telephone_number": "920-725-5357",
            "fax_number": "920-969-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5223-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina M. Heinzen, PA-C
• Charles Hejny, MD
• J Michael Helf, PA
• Karen Kristine Helfrich, R.D.
• Amy E Henderson, D.D.S.
• Brooke A Henschel, APNP
• Robert G Hering, DDS
• Megan Rae Herkstroeter, APNP
• Kim Grace Hermans, OTR
• Mark G Hermans, MD

• General Practice Dentistry in Neenah, WI
• Providers in Neenah, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.