Individual provider Active NPI

Elaina Berd-Vergier, D.D.S.

  • Prosthodontics
  • Englewood, NJ
National Provider Identifier
1154476570
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DI 19824 Issued in NJ
Practice address
420 Grand Ave
Suite 201
Englewood, NJ 07631-4152
Phone
(201) 568-9098
Fax
(201) 568-9544
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
Yes

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
Prosthodontics 1223P0700X DI 19824 NJ Primary

Addresses

Primary practice location

420 Grand Ave
Suite 201
Englewood, NJ 07631-4152

Mailing address

420 Grand Ave
Suite 201
Englewood, NJ 07631-4152
Phone (201) 568-9098

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
DI 19824NJMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154476570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 GRAND AVE",
            "address_2": "SUITE 201",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314152",
            "telephone_number": "201-568-9098",
            "fax_number": "201-568-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GRAND AVE",
            "address_2": "SUITE 201",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314152",
            "telephone_number": "201-568-9098",
            "fax_number": "201-568-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERD-VERGIER",
        "first_name": "ELAINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "DI 19824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • 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.