Lauren Berg, DDS
Individual provider Active NPI Endodontics · Phoenix, AZ
NPI 1164880779 · NPPES record last updated Oct 13, 2020
Key facts
- NPI
- 1164880779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- 9586 (AZ)
- Practice address
- 702 E Bell Rd Ste 111
Phoenix, AZ 85022-6639 - Phone
- (602) 482-7000
- NPI assigned
- Feb 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161229001831 | CA | Order and Referring Only - Dentist |
2062793235 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9586 | AZ | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Valley Endodontics, P.a. | Endodontics | Current |
Accepting new patients |
Locations
2979 W Elliot Rd
Ste 4
Chandler, AZ 85224
Phone (480) 775-1300
20100 N 51st Ave
Ste C310
Glendale, AZ 85308
Phone (623) 572-4300
20100 N 51st Ave
Ste C
Glendale, AZ 85308
14155 N 83rd Ave
Ste 141
Peoria, AZ 85381
Phone (623) 878-1000
4141 N 32nd St
Ste 100
Phoenix, AZ 85018
Phone (602) 404-3800
702 E Bell Rd
Ste 111
Phoenix, AZ 85022
Phone (602) 404-3800
7281 E Earll Dr
Ste 1
Scottsdale, AZ 85251
Phone (480) 634-4013
3085 W Ina Rd
Ste 101
Tucson, AZ 85741
Phone (520) 219-1900
6452 E Carondelet Dr
Ste 150
Tucson, AZ 85710
Phone (520) 296-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics |
1223E0200X | 9586 | AZ | Yes |
Addresses
Primary practice location
702 E Bell Rd Ste 111
Phoenix, AZ 85022-6639
Mailing address
7131 E Rancho Vista Dr Unit 3009
Scottsdale, AZ 85251-1463
Phone (318) 458-6915
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.