Provider Demographics
NPI:1013271030
Name:HENDRIX, DREW R (DDS)
Entity Type:Individual
Prefix:MR
First Name:DREW
Middle Name:R
Last Name:HENDRIX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:KINGFISHER
Mailing Address - State:OK
Mailing Address - Zip Code:73750-3524
Mailing Address - Country:US
Mailing Address - Phone:405-375-4949
Mailing Address - Fax:405-375-4946
Practice Address - Street 1:524 S 7TH ST
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750-3524
Practice Address - Country:US
Practice Address - Phone:405-375-4949
Practice Address - Fax:405-375-4946
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist