DANIEL M. HENRICKSEN DDS MS PLLC (NPI# 1821410663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821410663 |
| Entity Type | Organization |
| Organization Name | DANIEL M. HENRICKSEN DDS MS PLLC |
| Other Organization Name | HENRICKSEN FAMILY DENTAL |
| Practice Address |
1292 S Market Blvd Chehalis WA 98532-3645 |
| Practice Telephone | 3607484481 |
| Practice Fax Number | 3607407542 |
| Mailing Telephone | 3607484481 |
| Mailing Fax Number | 3607407542 |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2015-04-29 |
| Authorized Official Name | DANIEL M HENRICKSEN (DENTIST/OWNER) |
| Authorized Official Telephone | 3607484481 |
| Authorized Official Credential | D.D.S, M.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
5334800 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 5334800 | 05 | |
| WA | 2043379 | 05 |
| Other Name | Type Code |
|---|---|
| Henricksen Family Dental | Doing Business As Name - Organization |
| Street Address |
1292 S MARKET BLVD |
| City | CHEHALIS |
| State | WA |
| Zip Code | 98532-3645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588773428 | Richard R Walker Dds Ps | Dentist | 1292 S Market Blvd, Chehalis, WA 98532 | 2006-08-30 |
| 1003465964 | Wagner Orthodontics | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2019-09-04 |
| 1235676008 | Peter Louis Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2017-01-31 |
| 1609258029 | Ernest Mori Yamane | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2015-06-22 |
| 1568879690 | Daniel Henricksen | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2014-07-21 |
| 1548407570 | Ernest M. Yamane, Dds Ps | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2009-01-13 |
| 1609992932 | Peter C. Wagner | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1629194964 | Peter C. Wagner, D.m.d., P.s. | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2007-03-21 |
| 1235213893 | John Maack Henricksen | Dentist | 1292 S Market Blvd, Chehalis, WA 98532-3645 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140832 | Joshua Russell Wachter | Registered Nurse | 275 W. Vine St., Napavine, WA 98532 | 2020-09-28 |
| 1891339123 | Dara Casey | Technician | 271-1 Romerman Rd, Chehalis, WA 98532 | 2019-10-30 |
| 1265997704 | April D Bacongco | Counselor | 500 Se Washington St, Chehalis, WA 98532 | 2019-02-08 |
| 1235610155 | Alyssa Dawn Ware | Physical Therapist | 1441 Kresky Ave, Chehalis, WA 98532 | 2018-08-28 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1043709314 | Kevin Bumatay Duran | Family Medicine | 931 S. Market Blvd, Chehalis, WA 98532 | 2018-05-02 |
| 1164922324 | William I. Mcmillan | Counselor | 121 Nw Chehalis St., Chehalis, WA 98532 | 2018-02-14 |
| 1285155366 | Great Rivers Behavioral Health Organization | Community/Behavioral Health | 57 W Main Street, Suite 260, Chehalis, WA 98532 | 2017-06-29 |
| 1396273637 | Misty Anne Glenn | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532 | 2017-05-31 |
| 1841726221 | Dodi Forgione | Counselor | 2401 Ne Kresky Ave Ste D, Chehalis, WA 98532 | 2017-05-04 |
| Find all providers in zip 98532 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549831 | Eid, Jaber, Jassar, Pllc | Clinic/Center | 1461 Nw Louisiana Ave, Chehalis, WA 98532-1749 | 2020-02-10 |
| 1144726134 | Andrew J. Cole Dds Pllc | Clinic/Center | 388 Sw 13th St, Chehalis, WA 98532-3609 | 2018-03-30 |
| 1740785476 | John H Cho Dds LLC | Clinic/Center | 1299 Bishop Rd Ste B, Chehalis, WA 98532-8758 | 2018-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700671 | K.lee, Dds, Pllc. | Clinic/Center | 20709 Mountain Hwy E # 102, Spanaway, WA 98387-8580 | 2020-11-06 |
| 1346841376 | Ralf F. Schuler, Dr. Med. Dent., Msd,pllc | Clinic/Center | 205 W Fairhaven Ave Ste C, Burlington, WA 98233-1062 | 2020-11-05 |
| 1356942684 | Healthy Smiles Northwest | Clinic/Center | 11808 18th St Se, Lake Stevens, WA 98258-2046 | 2020-11-03 |
| 1306446240 | Christine A Woodward, Dds, Pllc | Clinic/Center | 45860 Main St, Concrete, WA 98237 | 2020-10-29 |
| 1215535695 | Ellingsen Henneberg Pllc | Clinic/Center | 2607 S Southeast Blvd Ste B210, Spokane, WA 99223-7614 | 2020-10-16 |
| 1174121792 | Evolve Dental LLC | Clinic/Center | 4410 194th St Sw Ste A, Lynnwood, WA 98036-5598 | 2020-10-15 |
| 1326646035 | Natasha Habib Dds Ps | Clinic/Center | 1025 153rd St Se Ste 103, Mill Creek, WA 98012-4051 | 2020-10-14 |
| 1386241636 | Mellissa Ilgen, Dds, Pllc | Clinic/Center | 26114 Illinois Ave Ne, Kingston, WA 98346-7674 | 2020-10-08 |
| 1417554932 | Young, Yeung, Lee, Hockin, P.s | Clinic/Center | 2207 2nd Ave, Seattle, WA 98121-2016 | 2020-10-07 |
| 1164039731 | Consolidated Dental Three | Clinic/Center | 19221 108th Ave Se Ste 2, Renton, WA 98055-7369 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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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.