Individual provider Active NPI

Deirdre S Herzer, CPDH COLLABORATIVE P

  • Dental Hygienist
  • Albuquerque, NM
National Provider Identifier
1033289657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH802 Issued in NM
Practice address
3003 Silver SE
Albuquerque, NM 87106-2243
Phone
(505) 256-3509
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH802 NM Primary

Addresses

Primary practice location

3003 Silver SE
Albuquerque, NM 87106-2243

Mailing address

3003 Silver SE
Albuquerque, NM 87106-2243
Phone (505) 256-3509

Other identifiers 1

IdentifierTypeStateIssuer
1800372OtherUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DH802NMMDDental Hygienist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033289657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 SILVER SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062243",
            "telephone_number": "505-256-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 SILVER SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062243",
            "telephone_number": "505-256-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZER",
        "first_name": "DEIRDRE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "CPDH COLLABORATIVE P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NM",
            "license": "DH802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1800372",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.