NPIMap

Organization Active NPI

Ponderosa Dental Arts, PC

  • Dentist
  • Oregon City, OR
National Provider Identifier
1003245606
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9967 Issued in OR
Legal business name
PONDEROSA DENTAL ARTS, PC
Practice address
1174 Molalla Ave
Oregon City, OR 97045-3770
Phone
(503) 656-6464
Fax
(503) 577-4677
NPI assigned
Nov 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eric D. Berkner, DMDNPI 1225316680
Title
Member/Owner
Phone
(506) 656-6464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D9967 OR Primary

Addresses

Primary practice location

1174 Molalla Ave
Oregon City, OR 97045-3770

Mailing address

1174 Molalla Ave
Oregon City, OR 97045-3770
Phone (503) 656-6464

National Provider Directory

National Provider Directory

Locations

1174 Molalla Ave
Oregon City, OR 97045
Phone (503) 646-6464

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1003245606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 MOLALLA AVE",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970453770",
            "telephone_number": "503-656-6464",
            "fax_number": "503-577-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 MOLALLA AVE",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970453770",
            "telephone_number": "503-656-6464",
            "fax_number": "503-577-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDEROSA DENTAL ARTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "BERKNER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "506-656-6464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.