Individual provider Active NPI

Benjamin Mark Berschler, D.M.D.

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1013918135
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7500 Issued in AZ
Practice address
111 W. Monroe Street
#131 Downtown Phoenix Dental
Phoenix, AZ 85003
Phone
(602) 626-7952
NPI assigned
Aug 10, 2005
Last updated
Jan 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7500 AZ
Dentist 122300000X D7500 AZ Primary

Addresses

Primary practice location

111 W. Monroe Street
#131 Downtown Phoenix Dental
Phoenix, AZ 85003

Mailing address

111 W. Monroe Street
#131 Downtown Phoenix Dental
Phoenix, AZ 85003
Phone (602) 626-7952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229001431 AZ Order and Referring Only - DentistPractitioner - Dentist 1951602424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7500AZMDDentist
D7500AZMDDentist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1013918135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W. MONROE STREET",
            "address_2": "#131 DOWNTOWN PHOENIX DENTAL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85003",
            "telephone_number": "602-626-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W. MONROE STREET",
            "address_2": "#131 DOWNTOWN PHOENIX DENTAL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85003",
            "telephone_number": "602-626-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSCHLER",
        "first_name": "BENJAMIN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "7500",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.