Raymond Heath Hendrickson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5136597-9922 Issued in UT

Practice address

2230 N. University Parkway
Suite 8a
Provo, UT 84604

Phone

(801) 370-0050

Fax

(801) 370-9635

NPI assigned

Aug 2, 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 names 1

• R. Heath Hendrickson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1932116589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 N UNIVERSITY PARKWAY",
            "address_2": "SUITE 8A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-370-0050",
            "fax_number": "801-370-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N. UNIVERSITY PARKWAY",
            "address_2": "SUITE 8A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-370-0050",
            "fax_number": "801-370-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "RAYMOND",
        "middle_name": "HEATH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "51365979922",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "5136597-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R.",
            "last_name": "HENDRICKSON",
            "middle_name": "HEATH",
            "credential": "DDS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kimberly Henderson
• Melanie Johnston Henderson, NNP
• Joshua Hendley
• Wendy Hendley, CSW
• Ethan Hendricks
• Samantha Dee Hendrickson, LAT, ATC
• Dallin Grant Hendry
• Lilliam Henningson, LCSW
• Bryan Andrew Henrie
• Jason D Henrie

• Dentist in Provo, UT
• Providers in Provo, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.