Lauren Alyssia Henderson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10849 Issued in TN

Practice address

5180 Park Ave Ste 210
Memphis, TN 38119-3530

Phone

(901) 763-0850

NPI assigned

Mar 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Dentalworks, Dr. Dietz & Associates (Park Avenue), P.C.

  • General Practice Dentistry
  • Memphis, TN
  • NPI 1023088523
  NPD (past)
• Interfaith Dental Clinic

  • Dentist
  • Nashville, TN
  • NPI 1811160781
  NPD (past)

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1992200364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 WALTER PAYTON LN",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575011",
            "telephone_number": "601-331-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 PARK AVE STE 210",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193530",
            "telephone_number": "901-763-0850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 Patterson St",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372032925",
            "country_code": "US",
            "telephone_number": "615-329-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LAUREN",
        "middle_name": "ALYSSIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10849",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerrika Olivia Henderson, DBH
• Joletta Kemp Henderson
• Kelsey Henderson, DO
• Kimberly Faith Henderson, NCC, LPC-MHSP (TEMP)
• Lauren Henderson, D.O.
• Mahogany Brandia Henderson, B.A.
• Margot Henderson, APRN, PNP-PC
• Megan Henderson
• Nathalie Kay Henderson, D.M.D
• Rachael Henderson, LMSW, LCSW

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.