Elizabeth A Herzberg, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5149-015 Issued in WI

Practice address

N6625 County Road a
Black River Falls, WI 54615-5852

Phone

(715) 284-3100

Fax

(715) 284-8115

NPI assigned

Dec 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

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.

• Black River Family Dentistry LTD

  • Dentist
  • Black River Falls, WI
  • NPI 1285778969
  NPD (past) Authorized official
• Black River Falls Dental LLC

  • Dentist
  • Black River Falls, WI
  • NPI 1790393270
  NPD (past)

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1659516516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6625 COUNTY ROAD A",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155852",
            "telephone_number": "715-284-3100",
            "fax_number": "715-284-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6625 COUNTY ROAD A",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155852",
            "telephone_number": "715-284-3100",
            "fax_number": "715-284-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZBERG",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5149-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Hastings, MS, LPC-IT
• Steve J Hegna, D.D.S.
• Paul E Helstad, D.P.M.
• Stephanie Anne Herman, M.S. CCC-SLP
• Steven Allen Herman, SACIT
• Vera Ellen Heubel, R.N.
• Heyde Health System, Inc
• Heyde Health System, Inc
• Ho Chunk Nation
• Ho Chunk Nation

• General Practice Dentistry in Black River Falls, WI
• Providers in Black River Falls, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.