DR. CHARLES VANCE HENDRICKSON (NPI# 1659485183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659485183 |
| Entity Type | Individual |
| Full Name | DR. CHARLES VANCE HENDRICKSON |
| Credential | DMD |
| Practice Address |
703 N Main St Mt Pleasant TN 38474 |
| Mailing Address |
Po Box 232 Mt Pleasant TN 38474 |
| Practice Telephone | 9313797711 |
| Practice Fax Number | 9313797729 |
| Mailing Telephone | 9313797711 |
| Mailing Fax Number | 9313797729 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS3102 | TN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS BLUE SHIELD | 0015890 | 01 |
| Street Address |
703 N MAIN ST |
| City | MT PLEASANT |
| State | TN |
| Zip Code | 38474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181531 | Michael L. Tyler Dds | Clinic/Center | 703 N Main St, Mt Pleasant, TN 38474-1015 | 2018-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750891677 | Diabetes Management Associates | Registered Nurse | 401 First Avenue, Mt. Pleasant, TN 38474 | 2017-10-05 |
| 1124107354 | Tadd T Thompson | Family Medicine | 4955 D Hwy 43 North, Mount Pleasant, TN 38474 | 2006-11-06 |
| 1275611600 | Delia Fernandez | Dentist | 703 N. Main St., Mt. Pleasant, TN 38474 | 2006-11-02 |
| 1225246630 | Carolyns Transportation | Non-emergency Medical Transport (VAN) | 108 Iris Dr, Mt Pleasant, TN 38474-1009 | 2007-05-18 |
| 1902909385 | Michael L Tyler | Dentist | 703 North Main Street, Mt Pleasant, TN 38474-1015 | 2006-09-07 |
| 1235619271 | Lynn Ruch | Physical Therapist | 815 N Main St, Mt Pleasant, TN 38474-1017 | 2018-08-20 |
| 1235639584 | Fast Pace Medical Clinic, Pllc | Family Medicine | 811 N Main St, Mt Pleasant, TN 38474-1017 | 2018-02-13 |
| 1174048268 | Walgreen Co | Pharmacy | 801 N Main St, Mt Pleasant, TN 38474-1017 | 2017-08-09 |
| 1952796575 | Mary Houston Hull | Registered Nurse | 811 N Main St, Mount Pleasant, TN 38474-1017 | 2015-03-31 |
| 1164832416 | Trever Hawkins | Nurse Practitioner | 811 N Main St, Mt Pleasant, TN 38474-1017 | 2014-05-07 |
| Find all providers in zip 38474 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174166334 | Jhansi Tulasi | Dentist | 2402 S Jefferson Ave, Mt Pleasant, TX 75455-5959 | 2019-10-21 |
| 1619359627 | Debra Gandy Adams | Dentist | 2053 Arundel Pl, Mt Pleasant, SC 29464-6201 | 2015-06-25 |
| 1013324797 | Austin Mcintyre | Dentist | 2860 S Green Bay Rd, Mt Pleasant, WI 53406-4962 | 2014-07-15 |
| 1043647233 | John C Assey | Dentist | 1041 Johnnie Dodds Blvd Ste 1, Mt Pleasant, SC 29464-6156 | 2013-10-02 |
| 1497066690 | Bryan Dental Office, Plc | Dentist | 1936 S Summerton Rd, Mt Pleasant, MI 48858-1109 | 2010-06-23 |
| 1033387782 | Frederick Roy Bonds Jr. | Dentist | 1231 N Mission St, Mt Pleasant, MI 48858-1050 | 2008-02-15 |
| 1033328620 | Al Ivester,dmd,pa | Dentist | 636 Long Point Rd Unit F, Belle Hall Shopping Center, Mt Pleasant, SC 29464-8286 | 2007-05-21 |
| 1184839912 | Bruce Merrill Larsen | Dentist | 240 N State St # 21, Mt Pleasant, UT 84647-1107 | 2007-05-14 |
| 1952515637 | Charles Middleton Anderson | Dentist | 317 Wingo Way, Suite 301, Mt Pleasant, SC 29464-1803 | 2007-05-10 |
| 1417171547 | Holecek Dental Services,p.c. | Dentist | 905 E Pickard St, Suite A, Mt Pleasant, MI 48858-1010 | 2007-04-12 |
| Find all providers in MT PLEASANT | ||||
| City | MT PLEASANT |
| Zip Code | 38474 |
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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.