Marvin Stephen Berman, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106997 Issued in CA

Practice address

3585 Round Barn Blvd Apt 306
Santa Rosa, CA 95403-0143

Phone

(707) 892-1744

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: marvin.berman.p1@direct.rrhc.nextgenshare.com
• Direct secure messaging: mberman743756@direct.ochin.org
• Direct secure messaging: marvin.berman.p1@direct.csvs.nextgenshare.com

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1114940020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 ROUND BARN BLVD APT 306",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030143",
            "telephone_number": "707-892-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 ROUND BARN BLVD APT 306",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030143",
            "telephone_number": "707-892-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "MARVIN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "033879",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "033879-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marvinberman@hotmail.com",
            "affiliation": "N",
            "address_1": "3585 Round Barn Blvd Apt 306",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954030143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Habteab Yohannes Berhane
• Jessica Berkana, LMFT
• Laura A. Berke, RN, FNP
• Jeremy Berlin
• Cynthia Carole Berman, PHD
• Claudia Bermudez
• Amador Herrera Bernal
• Rosalinda Bernal
• Deirdre Bernard Pearl, MD
• Karen Bernard-Flores

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.