Individual provider Active NPI

John Herchuk

  • General Practice Dentistry
  • Pawtucket, RI
National Provider Identifier
1992415699
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN03813 Issued in RI
Practice address
700 School St
Pawtucket, RI 02860-5747
Phone
(972) 322-6445
NPI assigned
Dec 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38718 TX
General Practice Dentistry 1223G0001X DEN03813 RI Primary

Addresses

Primary practice location

700 School St
Pawtucket, RI 02860-5747

Mailing address

189 Keach Pond Dr
Chepachet, RI 02814-2834
Phone (972) 322-6445

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN03813RIMDGeneral Practice Dentistry
38718TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1992415699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 KEACH POND DR",
            "city": "CHEPACHET",
            "state": "RI",
            "postal_code": "028142834",
            "telephone_number": "972-322-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SCHOOL ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605747",
            "telephone_number": "972-322-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERCHUK",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-05",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38718",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN03813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.