Individual provider Active NPI

Zachary Hernann, D.D.S.

  • Dentist
  • Aurora, CO
National Provider Identifier
1225476088
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00203107 Issued in CO
Practice address
12101 E 2ND Ave Ste 206
Aurora, CO 80011-8328
Phone
(303) 343-2161
Fax
(630) 917-0880
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 00203107 CO Primary
Dentist 122300000X 019029425 IL

Addresses

Primary practice location

12101 E 2ND Ave Ste 206
Aurora, CO 80011-8328

Mailing address

3009 E 92ND St
Chicago, IL 60617
Phone (773) 978-7801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00203107COMDDentist
019029425ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Pointe Dental PLLC CurrentSince Oct 19, 2020 Accepting new patients
Julie E Haberstroh DDS PastSince Dec 11, 2017 Accepting new patients

Locations

11410 Via Varra
Unit 400
Broomfield, CO 80020
Phone (720) 572-1617

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1225476088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 E 92ND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60617",
            "telephone_number": "773-978-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 E 2ND AVE STE 206",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118328",
            "telephone_number": "303-343-2161",
            "fax_number": "630-917-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANN",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00203107",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029425",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.