Charles F Hertzog, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS024908L Issued in PA

Practice address

118 Dickerson Rd
Suite D
North Wales, PA 19454-2538

Phone

(215) 699-9058

Fax

(215) 699-9599

NPI assigned

Aug 18, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1124250543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 DICKERSON RD",
            "address_2": "SUITE D",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194542538",
            "telephone_number": "215-699-9058",
            "fax_number": "215-699-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 DICKERSON RD",
            "address_2": "SUITE D",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194542538",
            "telephone_number": "215-699-9058",
            "fax_number": "215-699-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZOG",
        "first_name": "CHARLES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024908L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Hayward, PNP
• Aneesa Haywood
• George Reinicker Herr Jr., MD
• Hershman Present & Klein DMD
• Harold S Hershman, DMD
• Jill Higginson
• Max Samuel Hirsh, MSW
• Anne Hoffman, LPC
• Homestar Med Equip & Inf SVS
• Homewatch Caregivers of Havertown

• General Practice Dentistry in North Wales, PA
• Providers in North Wales, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.