Natacha Anne Herard-Exorphe, DDS
Individual provider Active NPI Dentist · Riverdale, IL
NPI 1497010540 · NPPES record last updated Mar 6, 2013
Key facts
- NPI
- 1497010540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019029060 (IL)
- Practice address
- 61 W 144TH St
Riverdale, IL 60827-2850 - Phone
- (708) 849-8627
- NPI assigned
- Jul 5, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230224001878 | IL | Order and Referring Only - Dentist |
1759754526 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salem & Shah Dental Group, PLLC | Past | Accepting new patients | |
| Ivanhoe Dental Group, LTD. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019029060 | IL | Yes |
Addresses
Primary practice location
61 W 144TH St
Riverdale, IL 60827-2850
Mailing address
220 Waltham St
Calumet City, IL 60409-5234
Phone (708) 868-6489
Other providers in Riverdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.