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Deactivated NPI 1982779369 Deactivated / Inactive NPI Male Practitioner

Dr. Michael Dorn Hendrickson , DDS

Dentist - Endodontics • Tempe, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Michael Hendrickson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 21, 2006
NPI Deactivation Date September 30, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Hendrickson, DDS was a registered Dentist - Endodontics practicing in Tempe, AZ. Throughout an active medical career spanning 14 years, Dr. Hendrickson provided care at the practice location at 2076 E SOUTHERN AVE until profile deactivation on 2020-09-30.

Practice Location & Contact Primary Location

Practice Address

2076 E Southern Ave
Suite C104

Tempe, AZ 852827520

Telephone 4808209774
Fax 4808205025
Associated Practice Facility / Clinic
🏢 J Stanley Reidhead Dds Pc Facility NPI 1104017326

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Endodontics in Tempe, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Tempe, AZ (152 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - Endodontics Primary Specialty

NUCC Taxonomy Code: 1223E0200X

State License AZ D2616

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1770699134

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 30, 2020

Record deactivated on September 30, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2076 E SOUTHERN AVE, SUITE C104, TEMPE, AZ 852827520 (Tel: 4808209774)

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Updated Business Mailing Address July 08, 2007

Registered at 2076 E SOUTHERN AVE, SUITE C104, TEMPE, AZ 852827520 (Tel: 4808209774)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL HENDRICKSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #D2616 in AZ)

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Initial NPI Registration & Enumeration November 21, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982779369
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 21, 2006
Last Update: July 08, 2007
Deactivation Date: September 30, 2020

Mailing Address

2076 E Southern Ave, Suite C104

Tempe, AZ 852827520

Phone: 4808209774

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.