Provider Demographics
NPI:1992900740
Name:HENDERSON, CHASITY ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHASITY
Middle Name:ANN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 KATY FWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2264
Mailing Address - Country:US
Mailing Address - Phone:832-673-0999
Mailing Address - Fax:281-657-2406
Practice Address - Street 1:8550 S BRAESWOOD BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-1109
Practice Address - Country:US
Practice Address - Phone:713-778-0999
Practice Address - Fax:713-490-6755
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice