Individual provider Active NPI

Mark D Berman, D.D.S.

  • General Practice Dentistry
  • Clinton Township, MI
National Provider Identifier
1104891985
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12453 Issued in MI
Practice address
44200 Garfield Rd
Suite 100
Clinton Township, MI 48038-1145
Phone
(586) 263-0770
Fax
(586) 263-9811
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12453 MI Primary

Addresses

Primary practice location

44200 Garfield Rd
Suite 100
Clinton Township, MI 48038-1145

Mailing address

44200 Garfield Rd
Suite 100
Clinton Township, MI 48038-1145
Phone (586) 263-0770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140923000883 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779768320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12453MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mark D. Berman, D.D.S. General Practice 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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104891985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44200 GARFIELD RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381145",
            "telephone_number": "586-263-0770",
            "fax_number": "586-263-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 GARFIELD RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381145",
            "telephone_number": "586-263-0770",
            "fax_number": "586-263-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.