Shawna G. Berndt, D.D.S.
Individual provider Active NPI Dentist · Fort Lupton, CO
NPI 1073732053 · NPPES record last updated Mar 23, 2014
Key facts
- NPI
- 1073732053
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 8634 (CO)
- Practice address
- 229 Denver Ave
Fort Lupton, CO 80621-1819 - Phone
- (303) 857-4377
- Fax
- (303) 857-1533
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8634 | CO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Lupton Dental Group P.C. | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8634 | CO | Yes |
Addresses
Primary practice location
229 Denver Ave
Fort Lupton, CO 80621-1819
Mailing address
229 Denver Ave
Fort Lupton, CO 80621-1819
Phone (303) 857-4377
Other providers in Fort Lupton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.