Active NPI
Paul Dana Herer, D.M.D.
- Pediatric Dentistry
- Lake Zurich, IL
National Provider Identifier
1689745457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 019014868
- Practice address
- 195 S Rand Rd
Suite110
Lake Zurich, IL 60047-2205 - Phone
- (847) 726-0300
- Fax
- (847) 726-3799
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 019014868 | IL | Primary |
Addresses
Primary practice location
195 S Rand Rd
Suite110
Lake Zurich, IL 60047-2205
Mailing address
195 South Rand Road
Suite 110
Lake Zurich, IL 66047
Phone (847) 726-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019014868 | IL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Dentistry Group, LLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Dentistry
- Lake Zurich, IL
- NPI 1497983688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245974400000",
"number": "1689745457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 SOUTH RAND ROAD",
"address_2": "SUITE 110",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "66047",
"telephone_number": "847-726-0300",
"fax_number": "847-726-3799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 S RAND RD",
"address_2": "SUITE110",
"city": "LAKE ZURICH",
"state": "IL",
"postal_code": "600472205",
"telephone_number": "847-726-0300",
"fax_number": "847-726-3799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERER",
"first_name": "PAUL",
"middle_name": "DANA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2009-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "019014868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Zurich, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.