Gary R Herberger, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019016466 Issued in IL

Practice address

336 N Main
Canton, IL 61520-1826

Phone

(309) 647-3331

Fax

(309) 649-5439

NPI assigned

Oct 20, 2006

Last updated

May 14, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Practice roles

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.

• Associates in Dentistry

  • Dentist
  • Canton, IL
  • NPI 1316029044
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1457433179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 LONGWOOD",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615201203",
            "telephone_number": "309-647-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 N MAIN",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615201826",
            "telephone_number": "309-647-3331",
            "fax_number": "309-649-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERGER",
        "first_name": "GARY",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Arthur Hanes, MPT
• Sandra Anne Haws, MS, RD, LDN
• Heartland of Canton Il LLC (Heartland Health Care Center - Canton)
• Crindy Nolee Hedges, RN, IBCLC
• Audrey Jo Hensley
• Mary Barbara Hodal, D.C.
• Angela J Holthaus, CRNA
• Suzanne E Holthaus, MD
• Ashley Nicole Howard, M.D.
• Patti Humphry, PT

• General Practice Dentistry in Canton, IL
• Providers in Canton, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.