DAVID J HENDERSON (NPI# 1417933284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417933284 |
| Entity Type | Individual |
| Full Name | DAVID J HENDERSON |
| Credential | MD |
| Practice Address |
620 East Medical Dr Suite 300 Bountiful UT 84010-5171 |
| Practice Telephone | 8012983247 |
| Practice Fax Number | 8012989675 |
| Mailing Telephone | 8012983247 |
| Mailing Fax Number | 8012989675 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2009-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 1593801205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 05356 | 05 | |
| UT | 1518109032 | 05 |
| 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 |
| 1992820773 | David J Henderson | Dentist | 857 S Auto Mall Rd, Bloomington, IN 47401-5447 | 2007-03-20 |
| 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 |
| Street Address |
620 EAST MEDICAL DR SUITE 300 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-5171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518109032 | Lakeview Urology & General Surgery LLC | Surgery | 620 East Medical Dr, Suite 300, Bountiful, UT 84010-5171 | 2009-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083922926 | Perry T. Walters, M.d. PC | Urology | 425 Medical Drive #112, Bountiful, UT 84010 | 2010-09-14 |
| 1790844165 | Perry T Walters | Urology | 425 Medical Dr, Suite 112, Bountiful, UT 84010 | 2006-12-08 |
| 1851314066 | Justin Paul Parkinson | Urology | 1551 Renaissance Towne Dr, Suite 370, Bountiful, UT 84010-7667 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945061 | Utah Urology Works LLC | Urology | 4252 S Highland Dr Ste 200, Salt Lake City, UT 84124-2690 | 2020-06-05 |
| 1619402286 | Andrew Mazzone | Urology | University of Utah Som Division of Urology, 30 North 1900 East, Salt Lake City, UT 84132-0001 | 2017-04-20 |
| 1588195135 | Laurel S. Mast | Urology | 30 N 1900 E Rm 3b427, Salt Lake City, UT 84132-0002 | 2017-03-24 |
| 1164845517 | Bruce Wayne Carlin | Urology | 375 Old Farm Ln, Coalville, UT 84017-6706 | 2014-01-21 |
| 1104182476 | Jeffrey David Sparenborg | Urology | 1157 N 300 W Ste 301, Provo, UT 84604-6124 | 2012-04-11 |
| 1588933527 | Hal H Bourne | Urology | 3250 Millcreek Dell Ln, Salt Lake City, UT 84109-3184 | 2011-12-20 |
| 1740598887 | Ihc Health Services Inc | Urology | 4403 Harrison Blvd Ste 4440, Ogden, UT 84403-3291 | 2010-09-23 |
| 1447589288 | Joseph Robert Armstrong | Urology | 3291 Piute Dr, Provo, UT 84604-4849 | 2009-12-07 |
| 1851627756 | Ned Legrande Mangelson | Urology | 2691 Roxbury Cir, Salt Lake City, UT 84108-2841 | 2009-10-27 |
| 1558593046 | Thomas S Brinton | Urology | 1380 E Medical Center Dr Ste 2100, St George, UT 84790 | 2009-08-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DAVID J HENDERSON.
| 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.