Individual provider Active NPI

Thomas Herron

  • General Practice Dentistry
  • Mayfield HTS, OH
National Provider Identifier
1154492858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30015154 Issued in OH
Practice address
5875 Landerbrook Dr Ste 250
Mayfield HTS, OH 44124-6502
Phone
(800) 487-4867
Fax
(216) 593-7533
NPI assigned
Nov 13, 2006
Sex
Male
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
General Practice Dentistry 1223G0001X 30015154 OH Primary

Addresses

Primary practice location

5875 Landerbrook Dr Ste 250
Mayfield HTS, OH 44124-6502

Mailing address

5875 Landerbrook Dr Ste 250
Mayfield HTS, OH 44124-6502
Phone (800) 487-4867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180827003798 OH Order and Referring Only - DentistPractitioner - Dentist 4981953718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30015154OHMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: thomas.herron.p19@direct.360care.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154492858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 LANDERBROOK DR STE 250",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441246502",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 LANDERBROOK DR STE 250",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441246502",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30015154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

Verify at the official NPI Registry.