Timothy M Herbst, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

2001012903 Issued in MO

Practice address

402 W Jefferson St
Kirksville, MO 63501-3407

Phone

(660) 665-2741

Fax

(660) 665-3109

NPI assigned

Dec 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Northeast Missouri Health Council, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kirksville, MO
  • NPI 1104829498

  Dentist

  NPD (past)

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1235115304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CROWN DRIVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012548",
            "telephone_number": "660-627-5757",
            "fax_number": "660-627-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013407",
            "telephone_number": "660-665-2741",
            "fax_number": "660-665-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBST",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2001012903",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MO",
            "license": "2001012903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408444107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mandie Helton
• Heidi B Henderson, RN
• Kristin Nicole Henke, PSYD
• Brandy Marie Pazdernik Hensch
• Kellie C Herbst, RDH
• India Deann Herrmann, PHARM.D.
• Nicholas Joseph Herrmann, PHARMD
• Brandon Herscovitch, PH.D., BCBA-D
• Justin Hicklin, DO
• James F Hicks, MS, LPC

• Public Health Dentistry in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Public Health Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.