Individual provider Active NPI

Mark Bernsdorf, D.D.S.

  • General Practice Dentistry
  • Hilliard, OH
National Provider Identifier
1043433873
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16824 Issued in OH
Practice address
3720 Ridge Mill Dr
Hilliard, OH 43026-9836
Phone
(614) 771-7788
Fax
(614) 771-7876
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16824 OH Primary

Addresses

Primary practice location

3720 Ridge Mill Dr
Hilliard, OH 43026-9836

Mailing address

3720 Ridge Mill Dr
Hilliard, OH 43026-9836
Phone (614) 771-7788

Other identifiers 1

IdentifierTypeStateIssuer
16824OtherOHLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16824OHMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: mark.bernsdorf.1@16701.direct.athenahealth.com
  • Direct secure messaging: mark.bernsdorf.1@17598.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1043433873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 RIDGE MILL DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430269836",
            "telephone_number": "614-771-7788",
            "fax_number": "614-771-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 RIDGE MILL DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430269836",
            "telephone_number": "614-771-7788",
            "fax_number": "614-771-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSDORF",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "16824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "16824",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilliard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.