Provider Demographics
NPI:1700945888
Name:HENAO-ALDREY, ANABELLA (DDS)
Entity Type:Individual
Prefix:
First Name:ANABELLA
Middle Name:
Last Name:HENAO-ALDREY
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 1:4600 SEBAGO TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3394
Mailing Address - Country:US
Mailing Address - Phone:617-319-6502
Mailing Address - Fax:
Practice Address - Street 1:225 E STATE HIGHWAY 121 # 100
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2005
Practice Address - Country:US
Practice Address - Phone:617-319-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics