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NPI Code Detail

MEDICARE: DR. ROBERT J. HERMAN D.D.S

MEDICARE: DR. ROBERT J. HERMAN D.D.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry5319CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053309047
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT J. HERMAN D.D.S
Provider Business Mailing Address
First Line : 2060 BLACK ROCK TPKE
Second Line :
City : FAIRFIELD
State : CT
Zip : 06825-3552
Country : US
Telephone Number : 203-330-9364
Fax Number : 203-330-9064
Provider Business Practice Location Address
First Line : 141 FRANKLIN ST
Second Line :
City : STAMFORD
State : CT
Zip : 06901-1014
Country : US
Telephone Number : 203-969-0802
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 03/18/2024

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