Active NPI
Kevin Shawn Berry, DDS
- General Practice Dentistry
- Denver, CO
National Provider Identifier
1003998485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7991
- Practice address
- 1660 S Albion St #1008
1008
Denver, CO 80222-4047 - Phone
- (303) 691-0267
- Fax
- (303) 691-0268
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7991 | CO | Primary |
Addresses
Primary practice location
1660 S Albion St #1008
1008
Denver, CO 80222-4047
Mailing address
1660 S Albion St #1008
Denver, CO 80222-4047
Phone (303) 691-0267
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 7, 2023 through Nov 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7991 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520899200000",
"number": "1003998485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 S ALBION ST #1008",
"city": "DENVER",
"state": "CO",
"postal_code": "802224047",
"telephone_number": "303-691-0267",
"fax_number": "303-691-0268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S ALBION ST #1008",
"address_2": "1008",
"city": "DENVER",
"state": "CO",
"postal_code": "802224047",
"telephone_number": "303-691-0267",
"fax_number": "303-691-0268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "KEVIN",
"middle_name": "SHAWN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2018-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "7991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.