Individual provider Active NPI

Jennifer Wilson Hershey, D.M.D.

  • General Practice Dentistry
  • O'Fallon, MO
National Provider Identifier
1750453429
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
012986 Issued in MO
Practice address
8803 Veterans Memorial Pkwy
O Fallon, MO 63366-7540
Phone
(636) 240-6992
Fax
(636) 272-6346
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 012986 MO Primary

Addresses

Primary practice location

8803 Veterans Memorial Pkwy
O Fallon, MO 63366-7540

Mailing address

8803 Veterans Memorial Pkwy
O Fallon, MO 63366-7540
Phone (636) 240-6992

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
012986MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750453429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8803 VETERANS MEMORIAL PKWY",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667540",
            "telephone_number": "636-240-6992",
            "fax_number": "636-272-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 VETERANS MEMORIAL PKWY",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667540",
            "telephone_number": "636-240-6992",
            "fax_number": "636-272-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHEY",
        "first_name": "JENNIFER",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "012986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.