Dwight L. Berry DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11639 Issued in MD

Legal business name

DWIGHT L. BERRY DDS PA

Practice address

420 Crain Hwy S
Suite 6
Glen Burnie, MD 21061-3657

Phone

(410) 766-6540

Fax

(410) 768-8049

NPI assigned

Jul 21, 2011

Organization subpart

No

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

Authorized official

Name

Dwight Leon Berry, DDSNPI 1417195116

Title

Owner

Phone

(410) 766-6540

Specialties & licenses 1

Addresses

Other names 1

• Dentcare Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dwight Leon Berry, D.D.S

  • General Practice Dentistry
  • Glen Burnie, MD
  • NPI 1417195116
  NPD (past) Authorized official

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1235427428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CRAIN HWY S",
            "address_2": "SUITE 6",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613657",
            "telephone_number": "410-766-6540",
            "fax_number": "410-768-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CRAIN HWY S",
            "address_2": "SUITE 6",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613657",
            "telephone_number": "410-766-6540",
            "fax_number": "410-768-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWIGHT L. BERRY DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-766-6540",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jewel F Duncan, LMSW, CAC-AD
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• General Practice Dentistry in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.