Organization Active NPI

Antuan L. Herriott, DMD, PA

  • Dentist
  • Lincolnton, NC
National Provider Identifier
1902259377
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8664 Issued in NC
Legal business name
ANTUAN L. HERRIOTT, DMD, PA
Practice address
821 E Sycamore St
Lincolnton, NC 28092-3427
Phone
(704) 735-3117
Fax
(704) 735-1107
NPI assigned
Jul 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Dr. Antuan L Herriott, DMDNPI 1477711539
Title
Owner
Phone
(704) 414-0461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 8664 NC Primary

Addresses

Primary practice location

821 E Sycamore St
Lincolnton, NC 28092-3427

Mailing address

821 E Sycamore St
Lincolnton, NC 28092-3427
Phone (704) 735-3117

Other identifiers 1

IdentifierTypeStateIssuer
5910047MedicaidNC

Other names 1

  • Lincolnton Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

821 E Sycamore St
Lincolnton, NC 28092
Phone (704) 735-3117

Practitioners & affiliated clinicians

Practitioners 1

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": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1902259377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E SYCAMORE ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923427",
            "telephone_number": "704-735-3117",
            "fax_number": "704-735-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E SYCAMORE ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280923427",
            "telephone_number": "704-735-3117",
            "fax_number": "704-735-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTUAN L. HERRIOTT, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "HERRIOTT",
        "authorized_official_first_name": "ANTUAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-414-0461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "8664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910047",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincolnton Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincolnton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.