Provider Demographics
NPI:1649652769
Name:HERPY, TODD ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALAN
Last Name:HERPY
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 1:2 SCIENCE CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1088
Mailing Address - Country:US
Mailing Address - Phone:402-640-6857
Mailing Address - Fax:
Practice Address - Street 1:2 SCIENCE CT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1088
Practice Address - Country:US
Practice Address - Phone:402-640-6857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1001123122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist