Provider Demographics
NPI:1851657670
Name:JEFFREY HENKES DDS
Entity Type:Organization
Organization Name:JEFFREY HENKES DDS
Other - Org Name:JEFFREY HENKES DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-788-9019
Mailing Address - Street 1:8131 CALLAGHAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4720
Mailing Address - Country:US
Mailing Address - Phone:210-788-9019
Mailing Address - Fax:
Practice Address - Street 1:8131 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4720
Practice Address - Country:US
Practice Address - Phone:210-788-9019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30642122300000X
WA00010925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty