Jeffrey Tod Herrell, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9622 Issued in MD

Practice address

174 Thomas Johnson Dr
Suite # 200
Frederick, MD 21702-4423

Phone

(301) 695-9446

Fax

(301) 695-6170

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 30, 2015 through Oct 30, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Modern Dentistry 1 LLC

  • General Practice Dentistry
  • Pasadena, MD
  • NPI 1265293732
  NPD (past)
• Raheleh Makhmalbaf DMD LLC

  • Dental Clinic/Center
  • Frederick, MD
  • NPI 1922898824
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1881672459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 THOMAS JOHNSON DR",
            "address_2": "SUITE # 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024423",
            "telephone_number": "301-695-9446",
            "fax_number": "301-695-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 THOMAS JOHNSON DR",
            "address_2": "SUITE # 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024423",
            "telephone_number": "301-695-9446",
            "fax_number": "301-695-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRELL",
        "first_name": "JEFFREY",
        "middle_name": "TOD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "9622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Lorena Hernandez
• Lismarie Ortiz Hernandez, RD
• Marlene Hernandez
• Melissa Alejandra Hernandez, MD
• Brenda Denise Herr, COTA
• Abigail Herring
• Margaret L. Herring, LCSW-C
• Jocelyn Mayer Hesen, LCSW-C
• Jeremy Charles Hewes, LCPC
• Pamela Warwick Hewetson, M.S.

• General Practice Dentistry in Frederick, MD
• Providers in Frederick, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.