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General NPI Number Information
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NPI Number | 1902484108
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Entity Type | Individual
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Provider Name | CURTIS HENDERSON DDS
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Gender | Male
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 831 S WASHINGTON ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4220
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Country | US
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Telephone | 703-549-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 750 N GLEBE RD APT 603
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City | ARLINGTON
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State | VA
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Zip | 22203-4450
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Country | US
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Telephone | 810-247-1544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401417989
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License Number State | VA
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