Active NPI
David Herald, DDS
- Dentist
- Cottonwood, AZ
National Provider Identifier
1093801656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7010
- Practice address
- 199 S Candy LN
Suite 4-a
Cottonwood, AZ 86326-4183 - Phone
- (928) 634-8046
- Fax
- (928) 649-0856
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7010 | AZ | Primary |
Addresses
Primary practice location
199 S Candy LN
Suite 4-a
Cottonwood, AZ 86326-4183
Mailing address
199 S Candy LN
Suite 4-a
Cottonwood, AZ 86326-4183
Phone (928) 634-8046
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150713000724 | AZ | Order and Referring Only - Oral Surgery | 4183936651 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7010 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1093801656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 S CANDY LN",
"address_2": "SUITE 4-A",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863264183",
"telephone_number": "928-634-8046",
"fax_number": "928-649-0856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "199 S CANDY LN",
"address_2": "SUITE 4-A",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863264183",
"telephone_number": "928-634-8046",
"fax_number": "928-649-0856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERALD",
"first_name": "DAVID",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "7010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cottonwood, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.