Provider Demographics
NPI:1730284423
Name:HENDRICK, JOSEPH ROCHEL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROCHEL
Last Name:HENDRICK
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:R
Other - Last Name:HENDRICK
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:511 NORTH MORGAN STREET
Mailing Address - Street 2:
Mailing Address - City:SHERBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150
Mailing Address - Country:US
Mailing Address - Phone:704-484-0077
Mailing Address - Fax:704-482-2229
Practice Address - Street 1:511 N MORGAN ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4436
Practice Address - Country:US
Practice Address - Phone:704-484-0077
Practice Address - Fax:704-482-2229
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8993792Medicaid