Active NPI
Camille Berres, DDS
- Dentist
- Eden Prairie, MN
National Provider Identifier
1083062384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D13655
- Practice address
- 18315 Cascade Dr Ste 120
Eden Prairie, MN 55347-1190 - Phone
- (952) 949-2536
- NPI assigned
- May 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D13655 | MN | Primary |
Addresses
Primary practice location
18315 Cascade Dr Ste 120
Eden Prairie, MN 55347-1190
Mailing address
2200 County Road C W
2210
Roseville, MN 55113-2550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D13655 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDG, P.a. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507680000000",
"number": "1083062384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 COUNTY ROAD C W",
"address_2": "2210",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551132550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18315 CASCADE DR STE 120",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553471190",
"telephone_number": "952-949-2536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRES",
"first_name": "CAMILLE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-26",
"last_updated": "2017-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.