1922395961 NPI number — DR. LINDSEY MARIE HENDERSON D.M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922395961 NPI number — DR. LINDSEY MARIE HENDERSON D.M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HENDERSON
Provider First Name:
LINDSEY
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHOWERS
Provider Other First Name:
LINDSEY
Provider Other Middle Name:
GASKIN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922395961
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 477 BOX 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FPO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96306-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-264-3612
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
US NAVY ATSUGI
Provider Second Line Business Practice Location Address:
FUKAYA OOGAMI, NMRTU ATSUGI, BUILDING 21, DENTAL CLINIC
Provider Business Practice Location Address City Name:
AYASE-SHI
Provider Business Practice Location Address State Name:
KANAGAWA-KEN
Provider Business Practice Location Address Postal Code:
2521101
Provider Business Practice Location Address Country Code:
JP
Provider Business Practice Location Address Telephone Number:
315-264-3612
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/28/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  3593-11 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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