Individual provider Active NPI

John Joseph Herber, D.D.S.

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1194948646
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009473 Issued in IN
Practice address
9925 Coldwater Rd
Fort Wayne, IN 46825-2041
Phone
(260) 489-8435
Fax
(260) 489-8535
NPI assigned
Apr 11, 2007
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 12009473 IN Primary

Addresses

Primary practice location

9925 Coldwater Rd
Fort Wayne, IN 46825-2041

Mailing address

9925 Coldwater Rd
Fort Wayne, IN 46825-2041
Phone (260) 489-8435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20161005002721 IN Order and Referring Only - DentistPractitioner - Dentist 4082902135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009473INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194948646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252041",
            "telephone_number": "260-489-8435",
            "fax_number": "260-489-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252041",
            "telephone_number": "260-489-8435",
            "fax_number": "260-489-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBER",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.