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Contact Information

KELLI HENDERSON, DDS
1425 WAKARUSA DR
SUITE D
LAWRENCE, KS66049-3832
 Phone: 405-706-6611
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for KELLI HENDERSON · (Female)

NPI Number 1497961338
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 05/15/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Yes
Identifiers
  • KS License # 60453
  • OK License # 5743
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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