Provider Demographics
NPI:1003089400
Name:RICK HENSLEY DMD III PA DBA LINCOLNTON FAMILY DENTISTRY
Entity Type:Organization
Organization Name:RICK HENSLEY DMD III PA DBA LINCOLNTON FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-735-3117
Mailing Address - Street 1:821 EAST SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:LICOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092
Mailing Address - Country:US
Mailing Address - Phone:704-735-3117
Mailing Address - Fax:704-735-1107
Practice Address - Street 1:821 E SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3427
Practice Address - Country:US
Practice Address - Phone:704-735-3117
Practice Address - Fax:704-735-1107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC66761223G0001X
NCNC86851223G0001X
NC86641223G0001X
NC87671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910047Medicaid
NC899003YMedicaid
1497981344OtherINDIVIDUAL NPI
NC5910817Medicaid
1972614600OtherINDIVIDUAL NPI
1477711539OtherINDIVIDUAL NPI
1528086428OtherINDIVIDUAL NPI