Individual provider Active NPI

Brooke Berge, RDH

  • Dental Hygienist
  • Jber, AK
National Provider Identifier
1124478599
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H8434 Issued in MN
Practice address
600 Richardson Dr
BLDG 634
Jber, AK 99505-8310
Phone
(907) 284-2483
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H8434 MN Primary
Dental Hygienist 124Q00000X DENH2237 AK

Addresses

Primary practice location

600 Richardson Dr
BLDG 634
Jber, AK 99505-8310

Mailing address

PO Box 212745
Anchorage, AK 99521-2745

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

LicenseStateTypeSpecialty
DENH2237AKMDDental Hygienist
H8434MNMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1124478599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212745",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995212745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 RICHARDSON DR",
            "address_2": "BLDG 634",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995058310",
            "telephone_number": "907-284-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGE",
        "first_name": "BROOKE",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H8434",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "AK",
            "license": "DENH2237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jber, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.