Mauricio Jose Herrera, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

0401413331 Issued in VA

Practice address

10601 Greenyard Way Ste B
Chester, VA 23831-1485

Phone

(804) 472-8099

Fax

(804) 270-4873

NPI assigned

Jul 11, 2008

Last updated

Jan 29, 2024By the provider in NPPES

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 names 1

• Mauricio J. Herrera Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1275797086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11545 A NUCKOIS ROAD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595666",
            "telephone_number": "804-673-8061",
            "fax_number": "804-673-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 GREENYARD WAY STE B",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311485",
            "telephone_number": "804-472-8099",
            "fax_number": "804-270-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "MAURICIO",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401413331",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "VA",
            "license": "0401413331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURICIO",
            "last_name": "HERRERA",
            "middle_name": "J.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Helping Our Community Rva
• James Alex Henderson Sr., HIS
• Rebecca Leah Henderson, LMFT
• Hans Hendrick, OTR/L
• Her Caring Heart, LLC
• Shyanna J Hicks, LCSW
• Him First Enterprises, LLC (Him First Home Health Services)
• Ellen Ho, O.D.
• Kimberly Hoang, OTD
• Quynh Anh Hoang, DDS

• Oral & Maxillofacial Surgery (D.M.D.) in Chester, VA
• Providers in Chester, VA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.