Dr Laurel Kelsey Alyssa Henderson, DDS is a medicare enrolled "Oral Medicinist" provider in Boston, Massachusetts. She went to University Of South Carolina School Of Medicine and graduated in 2013 and has 13 years of diverse experience with area of expertise as Oral Surgery. She is a member of the group practice Trustees Of Boston University and 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
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and 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 Surgery |
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| Experience | 13 Years |
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| Location | 725 Albany Street, 6th Floor, Boston, Massachusetts |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Laurel Kelsey Alyssa Henderson attended and graduated from University Of South Carolina School Of Medicine in 2013
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: I20251202001436
Medical Identifiers
Medical identifiers for Dr Laurel Kelsey Alyssa Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205309648 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223X2210X | Dentist - Orofacial Pain | 104477 (California) | Secondary |
| 125Q00000X | Oral Medicinist | 104477 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Trustees Of Boston University | 8921070822 | 43 |
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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