Provider Demographics
NPI:1376762039
Name:HENDRIX, MICHELLE DAWN GREEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DAWN GREEN
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11138 HOFFMAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4635
Mailing Address - Country:US
Mailing Address - Phone:301-253-1156
Mailing Address - Fax:
Practice Address - Street 1:11138 HOFFMAN DRIVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4635
Practice Address - Country:US
Practice Address - Phone:301-412-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9931122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist