Dr Laurel Kelsey Alyssa Henderson, DDS is a medicare enrolled "Oral Medicinist" provider in Boston, Massachusetts. Her current practice location is
725 Albany Street, 6th Floor, Suite 6a, Boston, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(617) 358-6775.
Dr Laurel Kelsey Alyssa Henderson is licensed to practice in California (license number 104477) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1205309648.
Healthcare Provider's Profile
Full Name | Dr Laurel Kelsey Alyssa Henderson |
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Gender | Female |
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Speciality | Oral Medicinist |
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Location | 725 Albany Street, 6th Floor, Boston, Massachusetts |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205309648
- Provider Enumeration Date: 01/08/2019
- Last Update Date: 07/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 7012244098
- Enrollment ID: I20190814000854
Medical Identifiers
Medical identifiers for Dr Laurel Kelsey Alyssa Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205309648 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223X2210X | Dentist - Orofacial Pain | 104477 (California) | Secondary |
125Q00000X | Oral Medicinist | 104477 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Laurel Kelsey Alyssa Henderson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Laurel Kelsey Alyssa Henderson, DDS 725 Albany Street, 6th Floor, Suite 6a, Boston, MA 02118 Ph: (617) 358-6775 | Dr Laurel Kelsey Alyssa Henderson, DDS 725 Albany Street, 6th Floor, Suite 6a, Boston, MA 02118 Ph: (617) 358-6775 |
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