Active NPI
Alice Berg, RDH
- Dental Hygienist
- Joint Base Lewis McChord, WA
National Provider Identifier
1154771236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 13046
- Practice address
- 527 Barnes Blvd
Joint Base Lewis McChord, WA 98438-1304 - Phone
- (253) 982-5505
- NPI assigned
- Jun 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 13046 | CA | Primary |
Addresses
Primary practice location
527 Barnes Blvd
Joint Base Lewis McChord, WA 98438-1304
Mailing address
PO Box 39793
Lakewood, WA 98496-3793
Phone (831) 206-7040
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 |
|---|---|---|---|
| 13046 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466380800000",
"number": "1154771236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 39793",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984963793",
"telephone_number": "831-206-7040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 BARNES BLVD",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984381304",
"telephone_number": "253-982-5505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "ALICE",
"name_prefix": "Ms.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-20",
"last_updated": "2016-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "13046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joint Base Lewis McChord, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.