Active NPI
Craig Alan Herwig, D.D.S
- Dentist
- Oklahoma City, OK
National Provider Identifier
1376573105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4031
- Practice address
- 1025 Straka Ter
Oklahoma City, OK 73139-2544 - Phone
- (405) 632-6688
- Fax
- (405) 604-0708
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4031 | OK | Primary |
Addresses
Primary practice location
1025 Straka Ter
Oklahoma City, OK 73139-2544
Mailing address
1025 Straka Ter
Oklahoma City, OK 73139-2544
Phone (405) 632-6688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150615000725 | OK | Order and Referring Only - Dentist | 9638480825 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4031 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1376573105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 STRAKA TER",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731392544",
"telephone_number": "405-632-6688",
"fax_number": "405-604-0708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 STRAKA TER",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731392544",
"telephone_number": "405-632-6688",
"fax_number": "405-604-0708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERWIG",
"first_name": "CRAIG",
"middle_name": "ALAN",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "4031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.