Mark R. Herzog, D.D.S., P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

038484 Issued in NY

Legal business name

MARK R. HERZOG, D.D.S., P.C.

Practice address

8421 Bay Pkwy
Brooklyn, NY 11214-3303

Phone

(718) 259-1110

Fax

(718) 259-1198

NPI assigned

Jun 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark R. Herzog, D.D.S.NPI 1467475095

Title

President

Phone

(718) 259-1110

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark R Herzog, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1467475095
  Authorized official Same address or phone

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639371511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8421 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143303",
            "telephone_number": "718-259-1110",
            "fax_number": "718-259-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8421 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143303",
            "telephone_number": "718-259-1110",
            "fax_number": "718-259-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R. HERZOG, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-259-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "038484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01200797",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Markland NP in Family Health, P.C.
• Mark Medical PC
• Mark Morano DPM PC
• Mark Novick MD PC
• Mark P Bell DPM
• Mark Russell MD PC
• Mark Zelnick Inc
• Christine Angella Mark-Duruaku
• Alexander Mark
• Arlene V Mark, LPN

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.