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NPI Code Detail

MEDICARE: DR. JORDAN HENKE DDS

MEDICARE: DR. JORDAN HENKE DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry10661SC

General Provider Information

NPI Number : 1154948867
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORDAN HENKE DDS
Provider Business Mailing Address
First Line : 91 SAMS POINT RD
Second Line :
City : BEAUFORT
State : SC
Zip : 29907-2010
Country : US
Telephone Number : 843-525-6866
Fax Number :
Provider Business Practice Location Address
First Line : 91 SAMS POINT RD
Second Line :
City : BEAUFORT
State : SC
Zip : 29907-2010
Country : US
Telephone Number : 843-525-6866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2020
Last Update Date : 06/05/2026

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