Organization Active NPI

Bruce L. Hern DDS, Robert N. Hern DDS, PC

  • Dentist
  • Ypsilanti, MI
National Provider Identifier
1801817796
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901012228 Issued in MI
Legal business name
BRUCE L. HERN DDS, ROBERT N. HERN DDS, PC
Practice address
1747 E Michigan Ave
Ypsilanti, MI 48198-6069
Phone
(734) 484-4710
Fax
(734) 484-4711
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bruce L. Hern, DDS
Title
Cob
Phone
(734) 484-4710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901012228 MI Primary

Addresses

Primary practice location

1747 E Michigan Ave
Ypsilanti, MI 48198-6069

Mailing address

1747 E Michigan Ave
Ypsilanti, MI 48198-6069
Phone (734) 484-4710

Other identifiers 2

IdentifierTypeStateIssuer
4874427MedicaidMI
4874436MedicaidMI

Other names 1

  • Hern Family Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

1747 E Michigan Ave
Ypsilanti, MI 48198
Phone (734) 484-4710

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801817796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 E MICHIGAN AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481986069",
            "telephone_number": "734-484-4710",
            "fax_number": "734-484-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 E MICHIGAN AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481986069",
            "telephone_number": "734-484-4710",
            "fax_number": "734-484-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE L. HERN DDS, ROBERT N. HERN DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "COB",
        "authorized_official_telephone_number": "734-484-4710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901012228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4874427",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4874436",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hern Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.