Individual provider Active NPI

Jason Thomas Herres, D.M.D.

  • General Practice Dentistry
  • Mount Joy, PA
National Provider Identifier
1952502791
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS037180 Issued in PA
Practice address
1013 W Main St
Suite #6
Mount Joy, PA 17552-9699
Phone
(717) 653-8177
NPI assigned
May 30, 2007
Last updated
Jun 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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 DS037180 PA Primary

Addresses

Primary practice location

1013 W Main St
Suite #6
Mount Joy, PA 17552-9699

Mailing address

1013 W Main St
Suite #6
Mount Joy, PA 17552-9699
Phone (717) 653-8177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708000202 PA Order and Referring Only - DentistPractitioner - Dentist 1759693518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS037180PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hugh Wenger DDS Associates General Practice Past Accepting new patients
JTH Dental Inc. General Practice PastSince Jun 12, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1952502791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 W MAIN ST",
            "address_2": "SUITE #6",
            "city": "MOUNT JOY",
            "state": "PA",
            "postal_code": "175529699",
            "telephone_number": "717-653-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 W MAIN ST",
            "address_2": "SUITE #6",
            "city": "MOUNT JOY",
            "state": "PA",
            "postal_code": "175529699",
            "telephone_number": "717-653-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRES",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Joy, PA

Sources for this page

Verify at the official NPI Registry.