NPIMap

Organization Active NPI

Coos County Family Health Services, Inc

Doing business as Coos County Family Dental - Berlin Site

  • Federally Qualified Health Center (FQHC)
  • Berlin, NH
National Provider Identifier
1073305850
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COOS COUNTY FAMILY HEALTH SERVICES, INC
Doing business as
Coos County Family Dental - Berlin Site
Practice address
54 Willow St
Berlin, NH 03570-2084
Phone
(603) 752-2424
NPI assigned
May 19, 2025
Last updated
May 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Kenneth E Gordon
Title
Ceo
Phone
(603) 752-3669

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

54 Willow St
Berlin, NH 03570-2084

Mailing address

133 Pleasant St
Berlin, NH 03570-2006
Phone (603) 752-2204

Other names 1

  • Coos County Family Dental - Berlin Site Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coos County Family Health Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

54 Willow St
Berlin, NH 03570
Phone (603) 752-2040

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1073305850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PLEASANT ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702006",
            "telephone_number": "603-752-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 WILLOW ST",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035702084",
            "telephone_number": "603-752-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOS COUNTY FAMILY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "603-752-3669"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coos County Family Dental - Berlin Site",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berlin, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.