Cherry Lane Dental

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

D-3409 Issued in ID

Legal business name

CHERRY LANE DENTAL

Practice address

1104 W Cherry LN
Meridian, ID 83642-1513

Phone

(208) 888-7889

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

John Andrew Bergloff, D.D.S.NPI 1326087180

Title

President

Phone

(208) 888-7889

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Andrew Bergloff, D.D.S.

  • Dentist
  • Meridian, ID
  • NPI 1326087180
  NPD (past) Authorized official
• Katie Lynn Garner, DMD

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1083405831
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083660021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421513",
            "telephone_number": "208-888-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421513",
            "telephone_number": "208-888-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY LANE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGLOFF",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-888-7889",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "ID",
            "license": "D-3409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Change Academy at Lake of the Ozarks
• Chatterbox Speech & Language Center
• Merrisa Chavez, RD
• Mark B Cheney, DO
• Cherry Heights Family Clinic LLC
• Cherry Lane Family Clinic, PA
• Cherry Lane Kids Dentistry
• Ciara Chesnut
• Darcy R Cheuvront, PHARMD
• Chiro Idaho Chiropractic PC

• Point of Service in Meridian, ID
• Providers in Meridian, ID by specialty
• Point of Service in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.