BRETT A HENRIKSON D.D.S. NPI 1063629988

NPI Information

  • NPI: 1063629988
  • Provider Name: BRETT A HENRIKSON, D.D.S.
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • Address: 2 EXECUTIVE DR STE A
    LAFAYETTE, IN
    ZIP 47905
  • Phone: (765) 807-0230

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NPI Details

Brett A Henrikson, D.D.S. is an oral and maxillofacial surgery dentist in Lafayette, IN. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Brett A Henrikson, D.D.S. NPI is 1063629988. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2 EXECUTIVE DR STE A
LAFAYETTE, IN
ZIP 47905-859
Phone: (765) 807-0230
Fax: (765) 807-0234

The enumeration date for this NPI number is 5/17/2007 and was last updated on 2/24/2011.

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
11223S0112XDentistOral and Maxillofacial Surgery12010155AINDIANAYes

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
1200471200MEDICAIDINDIANA

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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