Heronimo Paz, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

013514 Issued in MO

Practice address

507 N State Highway 47
Warrenton, MO 63383-1611

Phone

(636) 456-2454

Fax

(636) 456-1511

NPI assigned

Mar 21, 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

Other names 1

• Dr. H Jerry Paz Professional name

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366568362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N STATE HIGHWAY 47",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831611",
            "telephone_number": "636-456-2454",
            "fax_number": "636-456-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N STATE HIGHWAY 47",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831611",
            "telephone_number": "636-456-2454",
            "fax_number": "636-456-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZ",
        "first_name": "HERONIMO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H",
            "last_name": "PAZ",
            "middle_name": "JERRY",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Joseph D O'Brien
• Brian K Osmonson, D.C.
• Our Urgent Care, LLC
• Patients First Health Care LLC
• Paul J Dooley DDS PC
• Pec Warrenton LLC
• PFJ Corporation Inc
• Kendra Phan, DMD
• Picky Girl LLC
• Benjamin Nicholas Pirogovsky

• General Practice Dentistry in Warrenton, MO
• Providers in Warrenton, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.