Provider Demographics
NPI:1689457384
Name:REGINA HENDRIX, D.M.D., L.L.C.
Entity Type:Organization
Organization Name:REGINA HENDRIX, D.M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-566-1567
Mailing Address - Street 1:P.O. BOX 307
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081
Mailing Address - Country:US
Mailing Address - Phone:334-566-1567
Mailing Address - Fax:334-566-5401
Practice Address - Street 1:448 ELBA HIGHWAY
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36079
Practice Address - Country:US
Practice Address - Phone:334-566-1567
Practice Address - Fax:334-566-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty