Dr. Berry PC

Primary specialty

DentistTaxonomy code 122300000X

License

7991 Issued in CO

Legal business name

DR. BERRY PC

Practice address

1660 S Albion St
Suite 1008
Denver, CO 80222-4008

Phone

(303) 691-0267

Fax

(303) 691-0268

NPI assigned

Mar 22, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Shawn Berry, DDS

Title

Doctor of Dental Surgery

Phone

(303) 691-0267

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Koala Center for Sleep Disorders CO1 Doing business as

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1013448034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11825 STATE ROUTE 40",
            "address_2": "SUITE 100",
            "city": "DUNLAP",
            "state": "IL",
            "postal_code": "615258842",
            "telephone_number": "309-839-9941",
            "fax_number": "309-839-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S ALBION ST",
            "address_2": "SUITE 1008",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802224008",
            "telephone_number": "303-691-0267",
            "fax_number": "303-691-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BERRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "DOCTOR OF DENTAL SURGERY",
        "authorized_official_telephone_number": "303-691-0267",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "7991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1003998485",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BERRY PC ORGANIZATION (TYPE 2) NPI NUMBER",
            "identifier": "1962765651",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koala Center for Sleep Disorders CO1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Denver, CO
• Providers in Denver, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.