Provider Demographics
NPI:1427820042
Name:JULIE L. HENDRICKS, DDS, PC
Entity type:Organization
Organization Name:JULIE L. HENDRICKS, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-651-1112
Mailing Address - Street 1:13956 HIGHWAY F27 E
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-7688
Mailing Address - Country:US
Mailing Address - Phone:402-651-1112
Mailing Address - Fax:
Practice Address - Street 1:902 PARK ST
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2050
Practice Address - Country:US
Practice Address - Phone:641-236-6174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental