Active NPI
Louisa S Berman, DMD
- Prosthodontics
- Atlanta, GA
National Provider Identifier
1114242575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 12440
- Practice address
- 587 Virginia Ave NE
Suite 5
Atlanta, GA 30306-3695 - Phone
- (404) 433-3933
- NPI assigned
- Mar 29, 2010
- Last updated
- Aug 26, 2011
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 12440 | GA | Primary |
Addresses
Primary practice location
587 Virginia Ave NE
Suite 5
Atlanta, GA 30306-3695
Mailing address
4370 West Club Drive
Atlanta, GA 30319-3326
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 |
|---|---|---|---|
| 12440 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1114242575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4370 WEST CLUB DRIVE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303193326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "587 VIRGINIA AVE NE",
"address_2": "SUITE 5",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303063695",
"telephone_number": "404-433-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMAN",
"first_name": "LOUISA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-29",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "GA",
"license": "12440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.