Provider Demographics
NPI:1003017138
Name:HERRMAN, ALAN B (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:B
Last Name:HERRMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-2217
Mailing Address - Country:US
Mailing Address - Phone:316-755-1203
Mailing Address - Fax:316-755-1207
Practice Address - Street 1:201 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67147-2217
Practice Address - Country:US
Practice Address - Phone:316-755-1203
Practice Address - Fax:316-755-1207
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23253122300000X
KS608991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist