Devere J Herron, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019022784 Issued in IL

Practice address

7203 South Western Avenue
Chicago, IL 60636

Phone

(773) 476-5335

Fax

(773) 476-4353

NPI assigned

May 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Herron Family Dental Inc

  • Dentist
  • Chicago, IL
  • NPI 1821786831
  NPD Authorized official

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083826507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7203 SOUTH WESTERN AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60636",
            "telephone_number": "773-476-5335",
            "fax_number": "773-476-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7203 SOUTH WESTERN AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60636",
            "telephone_number": "773-476-5335",
            "fax_number": "773-476-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "DEVERE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "019022784",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Alden Herrold, MD, MPH
• Herron Family Dental Inc
• Herron Medical Services, S.C.
• Burnetta Herron, M.D.
• Denise Herron
• James R Herron, MD
• Jesse Dewayne Herron, APRN, CRNP, PMHNP-BC
• Mary Downs Herron, LCSW
• Mia Herron
• Monica M Herron, PA-C

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• 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.