1295909844 NPI number — RICK HENSLEY DMD II PA DBA MT VIEW FAMILY DENTISTRY

Table of content: (NPI 1295909844)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295909844 NPI number — RICK HENSLEY DMD II PA DBA MT VIEW FAMILY DENTISTRY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICK HENSLEY DMD II PA DBA MT VIEW FAMILY DENTISTRY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295909844
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3055 S 127 NC HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28602-8284
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-294-1448
Provider Business Mailing Address Fax Number:
828-294-1874

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3055 S NC 127 HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-8284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-294-1448
Provider Business Practice Location Address Fax Number:
828-294-1874
Provider Enumeration Date:
04/15/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HENSLEY
Authorized Official First Name:
RICK
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
828-294-1448

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  NC8685 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: NC5877 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: NC6676 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1972614600 . This is a "INDIVIDUAL NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1497981344 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 5910817 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1528086428 . This is a "INDIVIDUAL NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5910047 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 899003Y , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1477711539 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".