Individual provider Active NPI

Joe M. Herrera, DDS

  • General Practice Dentistry
  • Kansas City, KS
National Provider Identifier
1730178195
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6532 Issued in KS
Practice address
701 Washington Blvd.
Kansas City, KS 66101
Phone
(913) 362-8868
Fax
(913) 362-1780
NPI assigned
Oct 18, 2005
Last updated
Sep 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6532 KS Primary

Addresses

Primary practice location

701 Washington Blvd.
Kansas City, KS 66101

Mailing address

701 Washington Blvd.
Kansas City, KS 66101
Phone (913) 362-8868

Other identifiers 3

IdentifierTypeStateIssuer
15284016OtherMOBLUE CROSS BLUE SHIELD OF KC
100224130-AMedicaidKS
100224130AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20150408002388 KS Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557689247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Joe M. Herrera LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1730178195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WASHINGTON BLVD.",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66101",
            "telephone_number": "913-362-8868",
            "fax_number": "913-362-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WASHINGTON BLVD.",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66101",
            "telephone_number": "913-362-8868",
            "fax_number": "913-362-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "JOE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF KC",
            "identifier": "15284016",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100224130-A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100224130A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.