Provider Demographics
NPI:1114050002
Name:HENDERSON, BRYAN NEAL II (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:NEAL
Last Name:HENDERSON
Suffix:II
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 1:8325 WALNUT HILL LN STE 235
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4255
Mailing Address - Country:US
Mailing Address - Phone:214-265-7391
Mailing Address - Fax:214-265-7392
Practice Address - Street 1:8325 WALNUT HILL LN STE 235
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4255
Practice Address - Country:US
Practice Address - Phone:214-265-7391
Practice Address - Fax:214-265-7392
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX155651223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBH1848831OtherDEA