Individual provider Active NPI

Charles Herbert, D.D.S

  • Endodontics
  • Baltimore, MD
National Provider Identifier
1578595609
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12209 Issued in MD
Practice address
7939 Honeygo Blvd
Suite 227
Baltimore, MD 21236-4931
Phone
(410) 931-0250
Fax
(410) 931-4876
NPI assigned
Jul 7, 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
Endodontics 1223E0200X 12209 MD Primary

Addresses

Primary practice location

7939 Honeygo Blvd
Suite 227
Baltimore, MD 21236-4931

Mailing address

6075 Avalon Dr
Elkridge, MD 21075-5985
Phone (410) 540-9036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160406000356 MD Order and Referring Only - DentistPractitioner - Dentist 2668770785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578595609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 AVALON DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755985",
            "telephone_number": "410-540-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7939 HONEYGO BLVD",
            "address_2": "SUITE 227",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364931",
            "telephone_number": "410-931-0250",
            "fax_number": "410-931-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "CHARLES",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "12209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.