NPI 1992820773 · live from the CMS NPI Registry
David J Henderson, dds
Dentist, Orthodontics and Dentofacial Orthopedics in Bloomington, IN. National Provider Identifier 1992820773, active.
NPI record
| NPI | 1992820773 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 857 S Auto Mall Rd, Bloomington, IN 47401 |
| Practice phone | 812-333-1051 |
| Mailing address | 4611 Eagleview Dr, Bloomington, IN 47403 |
| Enumerated | March 20, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 12007864A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.