Matthew D. Berg, D.D.S., P.a.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D11937 Issued in MN

Legal business name

MATTHEW D. BERG, D.D.S., P.A.

Doing business as

Rice Creek Dental

Practice address

2193 Silver Lake Rd NW
New Brighton, MN 55112-5331

Phone

(651) 633-3116

NPI assigned

Apr 7, 2008

Last updated

May 20, 2008By 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. Matthew Douglas Berg, D.D.S.NPI 1679592141

Title

President

Phone

(651) 235-9227

Specialties & licenses 1

Addresses

Other names 1

• Rice Creek Dental Doing business as

Locations

Practitioners 2

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.

• Matthew Douglas Berg, DDS

  • Dentist
  • New Brighton, MN
  • NPI 1679592141
  NPD (past) Authorized official
• Mark W. Houston, DDS

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1770572414
  NPD (past)

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1063685493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2193 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551125331",
            "telephone_number": "651-633-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2193 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551125331",
            "telephone_number": "651-633-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW D. BERG, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-235-9227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D11937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rice Creek Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Alexander Martin, LADC, LPCC
• Meredith Anne Martyr, PHD
• Mary M. Trites, P.a.
• Marilyn Joy Fiske Mast, MS COUNSELING
• Susanna Elizabeth Matlon
• MBH-MN Medical Clinic PA
• Marzack Balasco McAllister, LADC
• Daniel McCoy, ARNP
• Anne McLellan
• Kristen McLeskey

• Dental Clinic/Center in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.