David Mark Herlevic, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7258 Issued in TN

Practice address

100 West MLK Blvd
Suite 603
Chattanooga, TN 37402-2514

Phone

(423) 756-3176

Fax

(423) 267-7575

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861556276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WEST MLK BLVD",
            "address_2": "SUITE 603",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022514",
            "telephone_number": "423-756-3176",
            "fax_number": "423-267-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WEST MLK BLVD",
            "address_2": "SUITE 603",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022514",
            "telephone_number": "423-756-3176",
            "fax_number": "423-267-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERLEVIC",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7258",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Henson
• Michelle Amanda Herbert, PHARMD
• Kathryn Herfurth
• Heritage Health Northeast Inc
• Heritage OB GYN Clinic of Chattanooga PLLC
• Lynne D Herman, ANP
• Ronald Herman III, PMHNP
• Michael Daniel Hermann, M.D.
• Alexander Hernandez-Tirado, MD
• Abiezer Taylor Hernandez, CRNA

• General Practice Dentistry in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• General Practice Dentistry in Tennessee

• 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.