Provider Demographics
NPI:1245228774
Name:HOOD, HENRY DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:DAVID
Last Name:HOOD
Suffix:
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 1:4501 LOUISE UNDERWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-3987
Mailing Address - Country:US
Mailing Address - Phone:502-368-2348
Mailing Address - Fax:502-368-2340
Practice Address - Street 1:4501 LOUISE UNDERWOOD WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-3987
Practice Address - Country:US
Practice Address - Phone:502-368-2348
Practice Address - Fax:502-368-2340
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY67951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0017594OtherPASSPORT NUMBER
KY60067956Medicaid