William Gerald Berg Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WI5000748-015 Issued in WI

Practice address

30 North 18TH Avenue
Sturgeon Bay, WI 54235

Phone

(920) 743-9275

Fax

(920) 743-1850

NPI assigned

Mar 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. W. Gerald Berg Jr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114047537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTH 18TH AVENUE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "54235",
            "telephone_number": "920-743-9275",
            "fax_number": "920-743-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTH 18TH AVENUE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "54235",
            "telephone_number": "920-743-9275",
            "fax_number": "920-743-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "WILLIAM",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "WI5000748-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W.",
            "last_name": "BERG",
            "middle_name": "GERALD",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bellin Psychiatric Center Inc (Bellin Behavior Health Sturgeon Bay)
• Lawrence R Bellmore III, MD
• Renee Therese Benzinger
• James W Berg, TEACHER
• Patrick Thomas Berg, DDS
• Victoria Marie Berry, D.D.S.
• Patricia Bertram, R.PH.
• Dylan Bielen, RPH
• Marc Paul Binard, M.D.
• Stephanie Birmingham

• General Practice Dentistry in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.