Amanda Henry DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

AMANDA HENRY DDS PC

Practice address

260 E Congress Pkwy Ste C
Crystal Lake, IL 60014-6235

Phone

(815) 459-4847

NPI assigned

Apr 16, 2025

Organization subpart

No

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

Authorized official

Name

Amanda HenryNPI 1982969770

Title

Owner

Phone

(847) 809-5312

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Henry, D.D.S

  • Dentist
  • Crystal Lake, IL
  • NPI 1982969770
  NPD (past) Authorized official
• Kay Henry, DDS

  • General Practice Dentistry
  • Crystal Lake, IL
  • NPI 1720115819
  NPD (past)

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1952197030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E CONGRESS PKWY STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E CONGRESS PKWY STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146235",
            "telephone_number": "815-459-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA HENRY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-809-5312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Crystal Lake, IL
• Providers in Crystal Lake, 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 Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.