Individual provider Active NPI

Michael P Berry, D.D.S.

  • Pediatric Dentistry
  • Parkville, MO
National Provider Identifier
1164412128
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE015875 Issued in MO
Practice address
6004 NW 9 Hwy.
Parkville, MO 64152
Phone
(816) 746-5437
Fax
(816) 746-8047
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DE015875 MO Primary

Addresses

Primary practice location

6004 NW 9 Hwy.
Parkville, MO 64152

Mailing address

6004 NW 9 Hwy.
Parkville, MO 64152
Phone (816) 746-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923000181 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911214010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE015875MOMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkville Pediatric Dentistry, LLC Pediatric Dentistry Past Accepting new patients
Michael P. Berry, D.D.S., P.C. Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164412128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6004 NW 9 HWY.",
            "city": "PARKVILLE",
            "state": "MO",
            "postal_code": "64152",
            "telephone_number": "816-746-5437",
            "fax_number": "816-746-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6004 NW 9 HWY.",
            "city": "PARKVILLE",
            "state": "MO",
            "postal_code": "64152",
            "telephone_number": "816-746-5437",
            "fax_number": "816-746-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "DE015875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MO

Sources for this page

Verify at the official NPI Registry.