DR. DAVID J HENDERSON (NPI# 1992820773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992820773 |
Entity Type | Individual |
Full Name | DR. DAVID J HENDERSON |
Credential | DDS |
Practice Address |
857 S Auto Mall Rd Bloomington IN 47401-5447 |
Mailing Address |
4611 Eagleview Dr Bloomington IN 47403-9043 |
Practice Telephone | 8123331051 |
Practice Fax Number | 8123338933 |
Mailing Telephone | 8128242782 |
Mailing Fax Number | 8123338933 |
Enumeration Date | 2007-03-20 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
12007864A | IN | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962644492 | David Kelso Henderson | Internal Medicine | Room 6 1480 Bldg 10, 10 Center Drive, Bethesda, MD 20892-0001 | 2009-03-30 |
1346400249 | David Duff Henderson | Psychiatry & Neurology | 1033 El Camino Real, Atascadero, CA 93422 | 2008-06-13 |
1265553762 | David C Henderson | Dentist | 113 North Pearl St, Carthage, MS 39051 | 2007-04-02 |
1578600227 | David J Henderson | Pediatrics | 2507 Battleground Ave, Suite B, Greensboro, NC 27408-4003 | 2007-01-31 |
1831245893 | David L Henderson | Psychiatry & Neurology | 5910 N Central Expy, Suite 790, Dallas, TX 75206-5125 | 2007-01-25 |
1306995527 | David Henderson | Internal Medicine | 531 Polk 77, Mena, AR 71953-7848 | 2007-01-09 |
1972679868 | David William Henderson | Pharmacist | 523 First St, Glasgow, MO 65254 | 2006-11-24 |
1215027289 | David T Henderson | Counselor | 301-a Palmetto Park Blvd, Lexington, SC 29072 | 2006-10-13 |
1700838570 | David V Henderson | Family Medicine | 312 S Maple St, Garnett, KS 66032 | 2006-05-17 |
1417933284 | David J Henderson | Urology | 620 East Medical Dr, Suite 300, Bountiful, UT 84010-5171 | 2005-12-22 |
Street Address |
857 S AUTO MALL RD |
City | BLOOMINGTON |
State | IN |
Zip Code | 47401-5447 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770964785 | Andrew Paul Watkins | Dentist | 857 S Auto Mall Rd, #4, Bloomington, IN 47401-5447 | 2015-06-16 |
1841505252 | Bloomington Oral Surgery LLC | Dentist | 857 S Auto Mall Rd, Bloomington, IN 47401-5447 | 2010-08-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740765791 | Holly G Carter | Physical Therapist | 3607 Heirloom Dr, Bloomington, IN 47401 | 2018-09-26 |
1285116657 | Kimberly D Bergan | Occupational Therapist | 3607 S Heirloom Dr, Bloomington, IN 47401 | 2018-09-03 |
1255836813 | Erin Kathleen Sain | Nurse Practitioner | 326 W Woodcrest Drive, Bloomington, IN 47401 | 2018-03-27 |
1881104289 | Ev Bloomington Limited Partnership | Assisted Living Facility | 3607 South Heirloom Drive, Bloomington, IN 47401 | 2017-10-11 |
1619496536 | Kirsten N Neely | Physical Therapist | 2604 E. Creek's Edge Dr., Bloomington, IN 47401 | 2017-09-12 |
1023533908 | Hoosier United Therapy Service LLC | Physical Therapist | 2801 E Plateau Place, Bloomington, IN 47401 | 2017-08-11 |
1194127381 | Ann Marie Neeley | Lactation Consultant, Non-RN | 2458 South Walnut Street, Bloomington, IN 47401 | 2014-09-19 |
1518397801 | Indiana Spine and Sports Inc. | Chiropractor | 418 S Walnut St Suite C, Bloomington, IN 47401 | 2013-11-22 |
1053654574 | William Robblee Anderson | Obstetrics & Gynecology | 2625 E. Spicewood Ct., Bloomington, IN 47401 | 2013-04-03 |
1285979377 | Jenna Marie Dale | Optometrist | 322 S. Woodcrest Drive Precision Eye Group, Bloomington, IN 47401 | 2012-11-30 |
Find all providers in zip 47401 |
Taxonomy Code | 1223X0400X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Orthodontics and Dentofacial Orthopedics |
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992290746 | Bbb of In, LLC | Dentist | 905 S College Mall Rd, Bloomington, IN 47401-6302 | 2018-06-25 |
1962796953 | Ann Z Granicz | Dentist | 1320 W Bloomfield Rd Ste B, Bloomington, IN 47403-2001 | 2011-06-07 |
1588819346 | Joshua Allan Chapman | Dentist | 3925 E. Hagan St., Suite 201, Bloomington, IN 47401 | 2008-11-20 |
1720255839 | Robert Lauder | Dentist | 111 N Regency Dr, Bloomington, IL 61701-3515 | 2008-05-08 |
1801173489 | Group Health Plan, Inc | Dentist | 8170 33rd Ave S, Bloomington, MN 55425-4516 | 2011-11-09 |
1285891192 | Francis Patrick Green | Dentist | 111 N Regency Dr, Bloomington, IL 61701-3515 | 2008-05-19 |
1134396336 | Scott Mathew Peterson | Dentist | 111 N Regency Dr, Bloomington, IL 61701-3515 | 2008-05-15 |
1518082643 | Coghlan Orthodontics | Dentist | 2911 E Covenanter Dr, Bloomington, IN 47401-6320 | 2007-03-20 |
1609990175 | Ocg Ltd | Dentist | 8600 Nicollet Ave S, Bloomington, MN 55420-2824 | 2007-03-19 |
1073637450 | Charles Y. Coghlan | Dentist | 2911 E Covenanter Dr, Bloomington, IN 47401-6320 | 2007-03-19 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 47401 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.