Individual provider Active NPI

William John Bero, DDS

  • Dentist
  • Manitowoc, WI
National Provider Identifier
1114031200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
2102 Marshall St
Manitowoc, WI 54220
Phone
(920) 684-9253
Fax
(920) 684-5250
NPI assigned
Aug 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X WI Primary

Addresses

Primary practice location

2102 Marshall St
Manitowoc, WI 54220

Mailing address

2102 Marshall St
Manitowoc, WI 54220
Phone (920) 684-9253

Other names 1

  • Dr. William John Bero Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20170119000015 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3678855137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003246015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114031200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 MARSHALL ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-684-9253",
            "fax_number": "920-684-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 MARSHALL ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-684-9253",
            "fax_number": "920-684-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERO",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "BERO",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.