NPIMap

Organization Active NPI

Craig Y. Bloom,DMD, Richard M.a. Berger,DDS & Bryan R. Krey, DMD, Apc

Doing business as Berkeley Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Berkeley, CA
National Provider Identifier
1194057174
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
31571 Issued in CA
Legal business name
CRAIG Y. BLOOM,DMD, RICHARD M.A. BERGER,DDS & BRYAN R. KREY, DMD, APC
Doing business as
Berkeley Oral Surgery
Practice address
2522 Dana St
Suite 202
Berkeley, CA 94704-2895
Phone
(510) 848-1055
Fax
(510) 848-1055
NPI assigned
Feb 2, 2010
Last updated
Feb 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Authorized official

Name
Dr. Craig Yale Bloom, D.M.D.NPI 1841344751
Title
President
Phone
(510) 848-1055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 31571 CA Primary

Addresses

Primary practice location

2522 Dana St
Suite 202
Berkeley, CA 94704-2895

Mailing address

2522 Dana St
Suite 202
Berkeley, CA 94704-2895
Phone (510) 848-1055

Other names 1

  • Berkeley Oral Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

2522 Dana St
Ste 202
Berkeley, CA 94704
Phone (510) 848-1055

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1194057174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 DANA ST",
            "address_2": "SUITE 202",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042895",
            "telephone_number": "510-848-1055",
            "fax_number": "510-848-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 DANA ST",
            "address_2": "SUITE 202",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042895",
            "telephone_number": "510-848-1055",
            "fax_number": "510-848-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG Y. BLOOM,DMD, RICHARD M.A. BERGER,DDS & BRYAN R. KREY, DMD, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "YALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-848-1055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "31571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berkeley Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.