Provider Demographics
NPI:1942385406
Name:HERPY, ALLEN KEITH (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:KEITH
Last Name:HERPY
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
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Mailing Address - Street 1:6770 MAXFIELD RD
Mailing Address - Street 2:#420
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-460-2820
Mailing Address - Fax:440-460-2830
Practice Address - Street 1:6770 MAYFIELD RD
Practice Address - Street 2:#420
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-460-2820
Practice Address - Fax:440-460-2830
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2012-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH30018513204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U52141Medicare UPIN
OHAL9274391Medicare ID - Type Unspecified