Edward L. Herod
Individual provider Active NPI General Practice Dentistry · Brooker, FL
NPI 1992944599 · NPPES record last updated Feb 5, 2009
Key facts
- NPI
- 1992944599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- AH2308181 (FL)
- Practice address
- 23320 N State Road 235
Brooker, FL 32622-5266 - Phone
- (352) 485-2772
- Fax
- (352) 485-1961
- NPI assigned
- Feb 5, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AH2308181 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alachua County Organization for Rural Needs, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | AH2308181 | FL | Yes |
Addresses
Primary practice location
23320 N State Road 235
Brooker, FL 32622-5266
Mailing address
23320 North State Road 235
Brooker, FL 32622-5266
Phone (352) 485-2772
Other providers in Brooker, FL
- Alachua County Organization for Rural Needs, Inc.
- Paayal Bhakta
- Lawrence Walter Dupee
- Marc T Frazer
- Karolyn Godbey
- Sally Martin
- Lisa Molitor
- Brian Morgan
- Abigail Elizabeth Palmer
- Dale Ryon
All providers in Brooker, FL · General Practice Dentistry in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.