Michael W Berry DDS PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

014845 Issued in MO

Legal business name

MICHAEL W BERRY DDS PC

Practice address

110 E Rollins St
Moberly, MO 65270-2269

Phone

(660) 263-1133

Fax

(660) 263-9181

NPI assigned

Oct 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Wayne Berry, D.D.S.NPI 1497775530

Title

Dentist Owner

Phone

(660) 263-1133

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael W Berry, DDS

  • General Practice Dentistry
  • Moberly, MO
  • NPI 1497775530
  NPD (past) Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063596088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROLLINS ST",
            "address_2": "P.O. BOX 517",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652702269",
            "telephone_number": "660-263-1133",
            "fax_number": "660-263-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E ROLLINS ST",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652702269",
            "telephone_number": "660-263-1133",
            "fax_number": "660-263-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL W BERRY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "660-263-1133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MO",
            "license": "014845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Moberly, MO
• Providers in Moberly, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.