Individual provider Active NPI

Anne S. Hertzberg, DMD

  • Pediatric Dentistry
  • Needham, MA
National Provider Identifier
1285832261
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
21837 Issued in MA
Practice address
87 Chestnut St
Needham, MA 02492-2578
Phone
(781) 444-6650
Fax
(781) 444-3607
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 21837 MA Primary

Addresses

Primary practice location

87 Chestnut St
Needham, MA 02492-2578

Mailing address

87 Chestnut St
Needham, MA 02492-2578
Phone (781) 444-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624000273 MA Order and Referring Only - DentistPractitioner - Dentist 5496066094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21837MAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1285832261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 CHESTNUT ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922578",
            "telephone_number": "781-444-6650",
            "fax_number": "781-444-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 CHESTNUT ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922578",
            "telephone_number": "781-444-6650",
            "fax_number": "781-444-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZBERG",
        "first_name": "ANNE",
        "middle_name": "S.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "21837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

Verify at the official NPI Registry.