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General NPI Number Information
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NPI Number | 1922395961
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Entity Type | Individual
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Provider Name | LINDSEY MARIE HENDERSON D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | US NAVY ATSUGI FUKAYA OOGAMI, NMRTU ATSUGI, BUILDING 21, DENTAL CLINIC
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City | AYASE-SHI
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State | KANAGAWA-KEN
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Zip | 2521101
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Country | JP
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Telephone | 315-264-3612
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 477 BOX 2
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City | FPO
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State | AP
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Zip | 96306-0001
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Country | US
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Telephone | 315-264-3612
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 3593-11
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License Number State | MS
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