Individual provider Active NPI

Robert M. Hersh, DMD

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1891885158
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
036688 Issued in NY
Practice address
5524 Fillmore Ave FL 1
Brooklyn, NY 11234-4733
Phone
(718) 252-7912
NPI assigned
Oct 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2015

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 036688 NY Primary

Addresses

Primary practice location

5524 Fillmore Ave FL 1
Brooklyn, NY 11234-4733

Mailing address

5524 Fillmore Ave FL 1
Brooklyn, NY 11234-4733
Phone (718) 252-7912

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150624002997 NY Order and Referring Only - Other (Non-Physician) 9931410412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036688NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1891885158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 FILLMORE AVE FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344733",
            "telephone_number": "718-252-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5524 FILLMORE AVE FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344733",
            "telephone_number": "718-252-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSH",
        "first_name": "ROBERT",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.