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Contact Information

JASON D HENDERSON, DDS
8179 CAZENOVIA RD.
MANLIUS, NY13104
 Phone: 315-682-2466
 Fax: 315-682-3179
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JASON D HENDERSON · (Male)

NPI # 1093987216
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 03/27/2008
Last updated 06/13/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 054488
  • NY Medicaid 1316096340
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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