Provider Demographics
NPI:1891904843
Name:ALVEN L. HERSTIG, DDS, INC.
Entity Type:Organization
Organization Name:ALVEN L. HERSTIG, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HERSTIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-864-2140
Mailing Address - Street 1:5180 E MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2436
Mailing Address - Country:US
Mailing Address - Phone:614-864-2140
Mailing Address - Fax:
Practice Address - Street 1:5180 E MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2436
Practice Address - Country:US
Practice Address - Phone:614-864-2140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH134961223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty