Erich Phelps Heitman, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401410333 Issued in VA

Practice address

BLDG 38717, 38TH Street
USA Dentac
Ft Gordon, GA 30905-5660

Phone

(706) 787-6927

Fax

(706) 787-2082

NPI assigned

Jan 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699753608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 38717, 38TH STREET",
            "address_2": "USA DENTAC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 38717, 38TH STREET",
            "address_2": "USA DENTAC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITMAN",
        "first_name": "ERICH",
        "middle_name": "PHELPS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Lee Hatley, DMD
• Esther Hatzigeorgiou
• Rishaunda Hawes, MEDICAL ASSISTANT
• Devon Hawkins, M.D.
• Sarah M Heaton, M.D.
• Tamikio Kwan Henderson, LPN
• Robert William Herold, DDS
• Benjamin Herrera, M.D.
• Christopher A Herring
• Susan Ann Herrington, R.N.

• Dentist in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Dentist in Georgia

• 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.
• 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.