Provider Demographics
NPI:1639857444
Name:HEROLD, MARGARET MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARIE
Last Name:HEROLD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 N 135TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-6165
Mailing Address - Country:US
Mailing Address - Phone:402-212-6012
Mailing Address - Fax:
Practice Address - Street 1:713 N 132ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4000
Practice Address - Country:US
Practice Address - Phone:402-603-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7931122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist