Andrea Henderson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8909 Issued in KY

Practice address

1010 Main St S
MC Kee, KY 40447-7089

Phone

(606) 287-7104

Fax

(606) 287-4409

NPI assigned

Jun 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Andrea Tucker Former 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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1992026546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MAIN ST S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404477089",
            "telephone_number": "606-287-7104",
            "fax_number": "606-287-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MAIN ST S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404477089",
            "telephone_number": "606-287-7104",
            "fax_number": "606-287-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "TUCKER",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jack T Fifield, DDS
• Debby Floy Gray, PA
• Jamie Layne Grubb, DOCTOR OF PHARMACY
• Kathleen Halcomb, ARNP
• Health Help Incorporated
• Julie Lachelle Henderson, NP
• Angela Brooke Hignite, DO
• Hometown Family Clinic
• Tonya Renae Howard, APRN
• Julie Beth Isaacs, RN

• All providers in MC Kee, KY
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.