Provider Demographics
NPI:1285440198
Name:HENDERSON, BRITTANY NIKKOLINE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NIKKOLINE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8475 E 36TH AVE UNIT 216
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-4304
Mailing Address - Country:US
Mailing Address - Phone:817-914-8852
Mailing Address - Fax:
Practice Address - Street 1:2880 W HOLDEN PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3353
Practice Address - Country:US
Practice Address - Phone:303-953-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002025911124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist