South Penn PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTH PENN PLLC

Practice address

7120 S Pennsylvania Ave
Oklahoma City, OK 73159-3315

Phone

(405) 681-6601

NPI assigned

May 22, 2025

Last updated

May 27, 2025By 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

Joseph Trevor Berg, DDSNPI 1356190565

Title

Owner

Phone

(208) 497-7250

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Joseph Trevor Berg

  • General Practice Dentistry
  • Roy, UT
  • NPI 1356190565
  NPD Authorized official
• Anh Huyen Bui, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1336715010
  NPD
• William Martin Kohs, DDS

  • Dentist
  • Oklahoma City, OK
  • NPI 1558474015
  NPD (past)

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1073306098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 S PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731593315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 S PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731593315",
            "telephone_number": "405-681-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PENN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-497-7250",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Source Unlimited Inc
• Senna Sous, MD
• South Okc Women's Healthcare
• South Oklahoma Orthopedics Inc.
• South Park Health Care LLC (South Pointe Rehab and Care Center)
• South Side Dental Partners, PLLC (Comfort Dental Southwestern Ave)
• South Wellness Community Health Clinic
• South West Urgent Care Inc
• South Wind Women's Center
• John South, LPC

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.