Matthew Jackson Henry, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16175 Issued in FL

Practice address

6223 Sauterne Dr
Jacksonville, FL 32210-7728

Phone

(049) 771-0568

NPI assigned

Dec 12, 2006

Last updated

Aug 15, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• West Side Dental Associates

  dba Matthew J Henry DDS and Robert R Cowie DDS

  • Dental Clinic/Center
  • Jacksonville, FL
  • NPI 1841763539
  NPD Authorized official
• Matthew J Henry DDS PL

  • Dental Clinic/Center
  • Jacksonville, FL
  • NPI 1154890267
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1902967177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13624 MARSH HARBOR DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252641",
            "telephone_number": "305-336-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6223 SAUTERNE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107728",
            "telephone_number": "049-771-0568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "473 Blanding Blvd",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735002",
            "country_code": "US",
            "telephone_number": "904-272-7170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MATTHEW",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "16175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Henry
• Jerome Henry
• Joy Marie Henry, D.C.
• Kelsey Rhae Williams Henry, MD
• Magdala Henry
• Melisa Henry, MSN, APRN, PMHNP-BC
• Michael Lewis Henry, NP
• Miguel Henry
• Rebecca Basha Henry, LCSW
• Stephen M Henry, DMD

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.