Individual provider Active NPI

David P Bernal, DDS

  • General Practice Dentistry
  • Port Arthur, TX
National Provider Identifier
1245437102
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23405 Issued in TX
Practice address
7675 Memorial Blvd
Suite 200
Port Arthur, TX 77640-2015
Phone
(409) 853-3100
NPI assigned
Jul 2, 2007
Last updated
Jan 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23405 TX Primary

Addresses

Primary practice location

7675 Memorial Blvd
Suite 200
Port Arthur, TX 77640-2015

Mailing address

7675 Memorial Blvd
Suite 200
Port Arthur, TX 77640-2015
Phone (409) 853-3100

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

LicenseStateTypeSpecialty
23405TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David Bernal DDS, PLLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1245437102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MEMORIAL BLVD",
            "address_2": "SUITE 200",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402015",
            "telephone_number": "409-853-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MEMORIAL BLVD",
            "address_2": "SUITE 200",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402015",
            "telephone_number": "409-853-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.

Verify at the official NPI Registry.