Gary Robert Herron III

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00205200 Issued in CO

Practice address

171 Inner Loop Road
Fort Irwin, CA 92310

Phone

(915) 742-2685

NPI assigned

Aug 30, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1700506821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8208 APENNINES ST APT A",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "923102495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 INNER LOOP ROAD",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "92310",
            "telephone_number": "915-742-2685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Dentac bldg 128",
            "address_purpose": "LOCATION",
            "city": "Fort Bliss",
            "state": "TX",
            "postal_code": "79906",
            "country_code": "US",
            "telephone_number": "505-235-1192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRON",
        "first_name": "GARY",
        "middle_name": "ROBERT",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00205200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mya Latrice Harris
• Robin R Harrold
• Margaret A Hawthorne, RN
• Joshua Allen Hennis, X2
• Sergio Hernandez, DDS
• Aaron William Hildebrand
• Randall Thomas Hook, RN
• Mei Hua-Burns
• George Joseph Hucal, DDS
• Neil S Hurd, CRNA

• General Practice Dentistry in Fort Irwin, CA
• Providers in Fort Irwin, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.