DR. MARK A. HERZOG (NPI# 1275595290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275595290 |
| Entity Type | Individual |
| Full Name | DR. MARK A. HERZOG |
| Credential | D.D.S, P.A. |
| Practice Address |
804 E 8th St Ellsworth KS 67439-2535 |
| Practice Telephone | 7854725420 |
| Practice Fax Number | 7854728995 |
| Mailing Telephone | 7854725420 |
| Mailing Fax Number | 7854728995 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2013-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6296 | KS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100223300B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467475095 | Mark R Herzog | Dentist | 8421 Bay Pkwy, Brooklyn, NY 11214-3303 | 2006-07-25 |
| 1740662246 | Mark Brady Herzog | Dentist | 6520 226th Pl Se, Suite 200, Issaquah, WA 98027-8969 | 2015-06-22 |
| 1447373766 | Mark Herzog | General Acute Care Hospital | 924 N Howe St, Southport, NC 28461-3038 | 2007-04-10 |
| Street Address |
804 E 8TH ST |
| City | ELLSWORTH |
| State | KS |
| Zip Code | 67439-2535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487992004 | Mark A.herzog | Dentist | 804 E 8th St, Ellsworth, KS 67439-2535 | 2013-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639555634 | Karen Kobs | Pharmacist | 1105 E 15th, Ellsworth, KS 67439 | 2015-08-03 |
| 1629281431 | Cheryl Ann Rathbun | Social Worker | 1295 Hwy 14, Ellsworth, KS 67439 | 2007-05-08 |
| 1134165855 | Wayne Keith Wallert | Chiropractor | 307 Webb, Ellsworth, KS 67439 | 2006-06-21 |
| 1568753820 | Katie M Mcwilliams | General Practice | 1602 N Aylward Ave, Ellsworth, KS 67439 | 2011-04-21 |
| 1609918523 | Kyle Gwinner Od LLC | Optometrist | 801 E 3rd St, Ellsworth, KS 67439-0339 | 2007-02-14 |
| 1255889192 | Oak Creek Chiropractic, LLC. | Chiropractor | 519 Prairie Ln, Ellsworth, KS 67439-1504 | 2016-09-20 |
| 1386192227 | Lindsey Warta | Chiropractor | 519 Prairie Ln, Ellsworth, KS 67439-1504 | 2016-09-20 |
| 1679186209 | Jessica Cairo | Nurse Practitioner | 1607 State St, Ellsworth, KS 67439-1628 | 2020-08-24 |
| 1841436052 | Teasha Lee Choitz | Occupational Therapy Assistant | 1113 State St, Ellsworth, KS 67439-2144 | 2008-12-18 |
| 1609290089 | Sheri Jonsson | Dietitian, Registered | 1604 Aylward Ave, Ellsworth, KS 67439-2541 | 2014-02-06 |
| Find all providers in zip 67439 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811529522 | Wagner Auguste Dental Pllc | Dentist | 206 High St Ste D, Ellsworth, ME 04605-1741 | 2020-02-11 |
| 1548822596 | Eric L Bolduc | Dentist | 206 High St, Ellsworth, ME 04605-1741 | 2019-06-30 |
| 1306081666 | Mlh LLC | Dentist | 31 Commerce Park, Ellsworth, ME 04605 | 2008-12-15 |
| 1730219239 | Krisan Shaw | Dentist | 501 W. Lucas Lane, Ellsworth, WI 54011 | 2007-03-06 |
| 1184797714 | Barbara E Tashjian | Dentist | 412 W. Kinne St., Ellsworth, WI 54011-0238 | 2006-11-15 |
| 1417979386 | Joel Frederick Ackerman | Dentist | 99 Oak Street, Ellsworth, ME 04605 | 2006-07-23 |
| 1285682773 | Cental Kansas Dentistry, Pa | Dentist | 202 N Douglas Ave, Ellsworth, KS 67439-3216 | 2006-05-05 |
| 1609838200 | Peter Clifton Cummings | Dentist | 201 High St, Ellsworth, ME 04605-1715 | 2006-04-06 |
| 1629597562 | Supritha Nilam | Dentist | 72 Beechland Rd, Ellsworth, ME 04605-2533 | 2017-09-12 |
| 1396162020 | Shaw Family Dental Sc | Dentist | 501 W. Lucas Lane, Ellsworth, WI 54011 | 2014-03-19 |
| Find all providers in ELLSWORTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.