Provider Demographics
NPI:1053583161
Name:HENDRIX, HOHETE YOHANNES (DMD;MSD)
Entity type:Individual
Prefix:DR
First Name:HOHETE
Middle Name:YOHANNES
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:DMD;MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2676 CHARLESTOWN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2574
Mailing Address - Country:US
Mailing Address - Phone:812-945-5533
Mailing Address - Fax:
Practice Address - Street 1:2676 CHARLESTOWN RD STE 1
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2574
Practice Address - Country:US
Practice Address - Phone:317-224-8579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011079A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist