Jake Taylor Hendrickson
Dental Assistant
1667 Cochrane Cir Bldg 7495
Fort Carson
, Colorado 80913-4603
Jake Taylor Hendrickson
Dental Assistant
1667 Cochrane Cir Bldg 7495
Fort Carson
, Colorado 80913-4603
(719) 526-5537
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About
Features
Specialties
- Dental Assistant
Languages spoken
- English
Location
First Address
- Jake Taylor Hendrickson
- 1667 Cochrane Cir Bldg 7495
- Fort Carson, CO
- Zip : 80913-4603
- Phone : (719) 526-5537
Second Address
- Jake Taylor Hendrickson
- 1667 Cochrane Cir Bldg 7495
- Fort Carson, CO
- Zip : 80913-4603
- Phone : (719) 526-5537
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 126800000X | Dental Assistant |
National Provider Identifier
| NPI | 1235753344 |
|---|---|
| Provider Name | Jake Taylor Hendrickson |
| First Address | Fort Carson, CO 80913-4603 |
| Second Address | Fort Carson, CO 80913-4603 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/06/2020 |
| Last Update Date | 04/06/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.