Individual provider Active NPI

Eugene George Herman, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Rockville Centre, NY
National Provider Identifier
1912014010
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
032691-1 Issued in NY
Practice address
77 N Centre Ave
Ste 303
Rockville Centre, NY 11570-3923
Phone
(516) 766-3330
Fax
(516) 766-3563
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 032691-1 NY Primary

Addresses

Primary practice location

77 N Centre Ave
Ste 303
Rockville Centre, NY 11570-3923

Mailing address

77 N Centre Ave
Ste 303
Rockville Centre, NY 11570-3923
Phone (516) 766-3330

Other identifiers 2

IdentifierTypeStateIssuer
130740146OtherNYADA
00304765MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032691-1NYMDOral & Maxillofacial Surgery (D.M.D.)

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1912014010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 N CENTRE AVE",
            "address_2": "STE 303",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703923",
            "telephone_number": "516-766-3330",
            "fax_number": "516-766-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N CENTRE AVE",
            "address_2": "STE 303",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703923",
            "telephone_number": "516-766-3330",
            "fax_number": "516-766-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "EUGENE",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "032691-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADA",
            "identifier": "130740146",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00304765",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.