Provider Demographics
NPI:1174580815
Name:HENDLEY, THOMAS MONROE III (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MONROE
Last Name:HENDLEY
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PARKWAY CTR STE G1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3510
Mailing Address - Country:US
Mailing Address - Phone:412-937-1900
Mailing Address - Fax:
Practice Address - Street 1:2 PARKWAY CTR STE G1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220
Practice Address - Country:US
Practice Address - Phone:412-937-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADA0318031223D0004X
SC35041223G0001X
PADS0416431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZA9857Medicaid