DR. NILES WALTER HERROD (NPI# 1578646642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578646642 |
| Entity Type | Individual |
| Full Name | DR. NILES WALTER HERROD |
| Credential | DDS |
| Practice Address |
777 N 500 W Suite 102 Provo UT 84601-1541 |
| Mailing Address |
871 Osmond Ln Provo UT 84604-5264 |
| Practice Telephone | 8013754707 |
| Mailing Telephone | 8012257229 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1321679924 | UT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IHC | 20859 | 01 |
| Street Address |
777 N 500 W SUITE 102 |
| City | PROVO |
| State | UT |
| Zip Code | 84601-1541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699746529 | Jeffrey A Youngquist | Dentist | 777 N 500 W, Suite #201-a, Provo, UT 84601-1541 | 2006-01-30 |
| 1205288586 | Lyndi Jenson | Dentist | 777 N 500 W, Provo, UT 84601-1541 | 2016-07-11 |
| 1922474956 | Rock Canyon Dentistry | Dentist | 777 N 500 W, #105, Provo, UT 84601-1541 | 2015-08-13 |
| 1700295227 | All Around Dental Care, Lc | Dentist | 777 N 500 W, Ste 106, Provo, UT 84601-1541 | 2014-08-08 |
| 1164846044 | Kyle Kone | Marriage & Family Therapist | 777 N 500 W, #104, Provo, UT 84601-1541 | 2014-02-12 |
| 1063833721 | Life Integrative Health Center | Clinic/Center | 777 N 500 W, Suite 104, Provo, UT 84601-1541 | 2013-12-26 |
| 1376985721 | Canyon View Medical Group LLC | Obstetrics & Gynecology | 777 N 500 W, Suite 203, Provo, UT 84601 | 2013-07-26 |
| 1306186952 | Edison Stanford Hearing Aid Center | Hearing Aid Equipment | 777 N 500 W, Suite 005, Provo, UT 84601-1541 | 2013-02-19 |
| 1861755571 | Devin Lynn Davidson | Dentist | 777 N 500 W, Suite 106, Provo, UT 84601-1541 | 2012-06-18 |
| 1932473188 | All Around Dental Care | Dentist | 777 N 500 W, 106, Provo, UT 84601-1541 | 2012-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346629441 | Eric Wood | Dentist | 3610 N University Ave Ste 150, Provo, UT 84604-4444 | 2015-05-21 |
| 1750404786 | David A Park | Dentist | 3610 N University Ave, Suite 150, Provo, UT 84604-4437 | 2007-04-06 |
| 1669595765 | Michael D Harris | Dentist | 3610 N University Ave, Suite 150, Provo, UT 84604-4437 | 2007-04-06 |
| 1649353715 | Gary Lyle Crawford | Dentist | 777 N 500 W, Provo, UT 84601-1541 | 2006-10-23 |
| 1093898157 | William Lecile Mcbee | Dentist | 777 N 500 W, Suite 102, Provo, UT 84601-1541 | 2006-10-23 |
| 1497838577 | Oral Maxillofacial Surgery Pllc | Dentist | 777 N 500 W, Suite 102, Provo, UT 84601-1541 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394631 | Vineyard Oral and Maxillofacial Surgery | Dentist | 707 E Mill Rd Ste 102, Vineyard, UT 84059-5732 | 2020-10-22 |
| 1306489059 | Alpine Dentists and Specialists Pllc | Dentist | 20 W Main Street Ct Ste 100, Alpine, UT 84004-1889 | 2019-10-25 |
| 1194213074 | Lehi Oral Surgery PC | Dentist | 2961 W Maple Loop Dr Ste 130, Lehi, UT 84043-5717 | 2018-04-26 |
| 1568974434 | Utah Wisdom Teeth, LLC | Dentist | 1030 E 11400 S Ste 2a, Sandy, UT 84094-6906 | 2017-10-31 |
| 1447623830 | Great Smiles Dental Clinic LLC | Dentist | 7410 S Creek Rd, #303, Sandy, UT 84093-6140 | 2015-11-06 |
| 1679943831 | Creekside Oral & Facial Surgery Inc | Dentist | 7390 S Creek Rd, Suite 101, Sandy, UT 84093-6119 | 2015-09-30 |
| 1023336104 | Adam C Stanley | Dentist | 3632 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7163 | 2010-05-13 |
| 1790012243 | Southern Utah Surgical Arts | Dentist | 393 E Riverside Dr Bldg 2, Suite 2b, St George, UT 84790-7065 | 2009-11-04 |
| 1487887204 | Joseph Fullmer | Dentist | 493 S Main St # 200, Heber City, UT 84032-2240 | 2009-08-27 |
| 1407085160 | Davis Center for Oral & Maxillofacial Surgery | Dentist | 890 Heritage Park Blvd Ste 103, Layton, UT 84041-5622 | 2009-07-02 |
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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.