Scott Henricksen DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5431 Issued in WA

Legal business name

SCOTT HENRICKSEN DDS

Practice address

701 N 182ND St # 120
Shoreline, WA 98133-4430

Phone

(206) 542-7600

Fax

(206) 542-7727

NPI assigned

Nov 20, 2014

Organization subpart

No

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

Authorized official

Name

J Scott Henricksen, DDS

Title

Owner Dentist

Phone

(206) 542-7600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1982001988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 182ND ST # 120",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334430",
            "telephone_number": "206-542-7600",
            "fax_number": "206-542-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 182ND ST # 120",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334430",
            "telephone_number": "206-542-7600",
            "fax_number": "206-542-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT HENRICKSEN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "HENRICKSEN",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "206-542-7600",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "5431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.