Joseph Bernard Herzog, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35900 Issued in CA

Practice address

5TH & Western
California Rehabilitation Center
Norco, CA 92860

Phone

(951) 737-2683

Fax

(951) 273-2326

NPI assigned

Dec 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198454400000",
    "number": "1265616338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72724 TWENTYNINE PALMS HWY",
            "address_2": "SUITE #102",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922771461",
            "telephone_number": "760-367-6755",
            "fax_number": "760-367-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5TH & WESTERN",
            "address_2": "CALIFORNIA REHABILITATION CENTER",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "92860",
            "telephone_number": "951-737-2683",
            "fax_number": "951-273-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "JOSEPH",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Norco, CA
• Providers in Norco, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2007; 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.