Individual provider Active NPI

David J Hernly, D.D.S.

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1376566489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18009 Issued in MI
Practice address
847 Parchment Dr SE
Suite 115
Grand Rapids, MI 49546-2303
Phone
(616) 957-1731
Fax
(616) 957-4420
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18009 MI Primary

Addresses

Primary practice location

847 Parchment Dr SE
Suite 115
Grand Rapids, MI 49546-2303

Mailing address

847 Parchment Dr SE
Suite 115
Grand Rapids, MI 49546-2303
Phone (616) 957-1731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18009MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hernly Family and Cosmetic Dentistry, PC General Practice PastSince May 1, 2007 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376566489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 PARCHMENT DR SE",
            "address_2": "SUITE 115",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462303",
            "telephone_number": "616-957-1731",
            "fax_number": "616-957-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 PARCHMENT DR SE",
            "address_2": "SUITE 115",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462303",
            "telephone_number": "616-957-1731",
            "fax_number": "616-957-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNLY",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.