Dwight David Heberer, D.M.D.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

019020320 Issued in IL

Practice address

226 Westview Plaza Dr.
Waterloo, IL 62298-2123

Phone

(618) 939-4042

Fax

(618) 939-5404

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr John F Blattner & Dr Dwight D Heberer PC

  • Customized Equipment (DME)
  • Waterloo, IL
  • NPI 1447400791

  General Practice

  NPD (past)
• Dr John F Blattner & Dr. Dwight D Heberer PC

  • Customized Equipment (DME)
  • Waterloo, IL
  • NPI 1215958855

  General Practice

  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1083786909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BASS LN",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622237626",
            "telephone_number": "618-476-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 WESTVIEW PLAZA DR.",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622982123",
            "telephone_number": "618-939-4042",
            "fax_number": "618-939-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERER",
        "first_name": "DWIGHT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020320",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "019020320",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "019020320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa I. Harris, LCPC, LMHC
• Brooke Hartmann, RSA
• Darryn Haudrich, LPC
• Kenneth D Hawn, MD
• Heart to Heart Pediatrics LLC
• Michala Heise
• Marsha Helferty, MHP
• Aaron P Henry, DPT
• Thomas Hensel, RSA
• Tonya Hensel, MHP

• Customized Equipment (DME) in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Customized Equipment (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.