Earl Douglas Henson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN007434 Issued in GA

Practice address

400 Cleveland Ave SW
Atlanta, GA 30315-8144

Phone

(404) 761-8455

Fax

(404) 761-2181

NPI assigned

Nov 7, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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.

• Metro Dental LLC

  • General Practice Dentistry
  • Atlanta, GA
  • NPI 1306056023
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952470437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CLEVELAND AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303158144",
            "telephone_number": "404-761-8455",
            "fax_number": "404-761-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CLEVELAND AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303158144",
            "telephone_number": "404-761-8455",
            "fax_number": "404-761-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "EARL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN007434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00051664B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Mayes Henschen, MD
• Grace Hensel
• Matthew Hensley
• Natalie Hensley
• Chelsea S Henson, N.P.
• Keisha M Henson
• Stuart Davis Hentz, DDS
• Kevin Yunhao Heo
• Suyeon Heo
• Milann D Hepburn, DPT

• General Practice Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• General Practice Dentistry in Georgia

• 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.