DIONNE NICOLE HENDERSON DDS NPI 1053422758

NPI Information

  • NPI: 1053422758
  • Provider Name: DIONNE NICOLE HENDERSON, DDS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 605 E 170TH ST
    SOUTH HOLLAND, IL
    ZIP 60473
  • Phone: (708) 893-0368

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NPI Details

Dionne Nicole Henderson, DDS is a general practice dentist in South Holland, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Dionne Nicole Henderson, DDS NPI is 1053422758. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

605 E 170TH ST
SOUTH HOLLAND, IL
ZIP 60473-408
Phone: (708) 893-0368
Fax: (708) 893-0456

The enumeration date for this NPI number is 8/31/2006 and was last updated on 10/8/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice2901017114MICHIGANNo
21223G0001XDentistGeneral Practice019023986ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14231409MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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