Niles Walter Herrod, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1321679924 Issued in UT

Practice address

777 N 500 W
Suite 102
Provo, UT 84601-1541

Phone

(801) 375-4707

NPI assigned

Oct 23, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1578646642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 OSMOND LN",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846045264",
            "telephone_number": "801-225-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 102",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011541",
            "telephone_number": "801-375-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERROD",
        "first_name": "NILES",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "1321679924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "20859",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Leanna Herold
• Christian Yanez Herrera, MD
• Madelyn Sara Herrick
• Darby Melesse Herrmann, OTR/L
• Keri L Herrmann, MD
• Alexis Kaye Heslop
• Breanna Hess
• Dennis C Hess, M.D.
• Sarah Heuser
• Spencer Hewitt

• Oral and Maxillofacial Surgery (Dentist) in Provo, UT
• Providers in Provo, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.