Healthcare Provider Details

I. General information

NPI: 1346320942
Provider Name (Legal Business Name): NANCY HERBST DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY HERBST-MODIANO DDS

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 44TH ST
UNION CITY NJ
07087-5012
US

IV. Provider business mailing address

312 44TH ST
UNION CITY NJ
07087-5012
US

V. Phone/Fax

Practice location:
  • Phone: 201-601-9262
  • Fax: 973-297-1551
Mailing address:
  • Phone: 201-601-9262
  • Fax: 201-601-2543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDI18881
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: