Individual provider Active NPI

Michael Christopher Herren, DMD

  • General Practice Dentistry
  • London, KY
National Provider Identifier
1457375594
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7414 Issued in KY
Practice address
823 South Main Street
London, KY 40741
Phone
(606) 864-4744
Fax
(606) 878-7235
NPI assigned
Jul 26, 2006
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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 7414 KY Primary

Addresses

Primary practice location

823 South Main Street
London, KY 40741

Mailing address

823 South Main Street
London, KY 40741
Phone (606) 864-4744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20140327002321 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042441438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Herren Family Dentistry Dre LLC CurrentSince Jun 25, 2023 Accepting new patients
Michael C Herren DMD Past Accepting new patients

Locations

823 S Main St
London, KY 40741
Phone (606) 864-4744

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1582070400000",
    "number": "1457375594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 SOUTH MAIN STREET",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-864-4744",
            "fax_number": "606-878-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 SOUTH MAIN STREET",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-864-4744",
            "fax_number": "606-878-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERREN",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.