James P. Herzog, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1832 Issued in MT

Practice address

2423 Cornell Ave
Butte, MT 59701-3848

Phone

(406) 494-7033

Fax

(406) 494-8256

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Mihailovich Family Dentistry LLC

  • Dental Clinic/Center
  • Butte, MT
  • NPI 1447805304
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649378662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 CORNELL AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597013848",
            "telephone_number": "406-494-7033",
            "fax_number": "406-494-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 CORNELL AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597013848",
            "telephone_number": "406-494-7033",
            "fax_number": "406-494-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "JAMES",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130273",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS INSURANCE",
            "identifier": "18324",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi Henderson
• Caitlin Hendrick
• Ronald Hendrickson, LAC
• Amanda Hennessey
• Sheena Mickael Hensley
• Alicia Sharon Hettel, APRN
• Tessa Lee Heuermann, MSW
• High Country Lung & Sleep Disorders Clinic, PC
• Highland Assisted Living Inc
• Highland Family Chiropractic, P.C.

• General Practice Dentistry in Butte, MT
• Providers in Butte, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.