Kathleen Herzog, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H5492 Issued in OR

Practice address

9000 SW Durham Rd
Building 710
Tigard, OR 97224-5539

Phone

(503) 359-4057

Fax

(503) 359-4756

NPI assigned

Jul 30, 2015

Last updated

Jul 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen Chirdon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Tigard, OR
  • NPI 1194099234
  NPD (past)

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1205212388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971130568",
            "telephone_number": "503-352-8657",
            "fax_number": "503-352-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SW DURHAM RD",
            "address_2": "BUILDING 710",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972245539",
            "telephone_number": "503-359-4057",
            "fax_number": "503-359-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "KATHLEEN",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H5492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "CHIRDON",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Nathiel Herrera
• Elizabeth Wolz Herring, MA, CCC-SLP
• Callum Herrmann
• Gabriela Canjura Herrmann, MSW
• Katelyn Elizabeth Hershberger, LPC
• James Marsden Hesla, D.M.D.
• Sarah Hess
• Eric J Hester, M.D.
• Zachary Hewson
• Lindsay K. Heydenrych, PSY.D.

• Dental Hygienist in Tigard, OR
• Providers in Tigard, OR by specialty
• Dental Hygienist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.