Provider Demographics
NPI:1467506121
Name:HENEGAR, ARTHUR W (DDS)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:W
Last Name:HENEGAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7475 LAS COLINAS BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-7583
Mailing Address - Country:US
Mailing Address - Phone:972-594-6915
Mailing Address - Fax:
Practice Address - Street 1:7475 LAS COLINAS BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7583
Practice Address - Country:US
Practice Address - Phone:972-594-6915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175310507Medicaid
TX175310508Medicaid
TX175310502Medicaid