Provider Demographics
NPI:1053409672
Name:HENDRICKX, JAMES GEORGE (DDS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:GEORGE
Last Name:HENDRICKX
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 1:1909 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-7960
Mailing Address - Country:US
Mailing Address - Phone:847-356-0260
Mailing Address - Fax:847-265-0365
Practice Address - Street 1:1909 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-7960
Practice Address - Country:US
Practice Address - Phone:847-356-0260
Practice Address - Fax:847-265-0365
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice