John Russell Berry, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2380 Issued in AR

Practice address

1220 N Division St
Forrest City, AR 72335-2307

Phone

(870) 633-4219

Fax

(870) 633-4120

NPI assigned

Jan 25, 2010

Last updated

Jan 25, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dr Russell Berry DDS PA

  • General Practice Dentistry
  • Forrest City, AR
  • NPI 1518079177
  NPD (past) Authorized official
• J R Berry DDS PC

  • General Practice Dentistry
  • Forrest City, AR
  • NPI 1770811341
  NPD (past) Authorized official

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1255662680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N DIVISION ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352307",
            "telephone_number": "870-633-4219",
            "fax_number": "870-633-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N DIVISION ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352307",
            "telephone_number": "870-633-4219",
            "fax_number": "870-633-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103180608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Bean
• Thomas J Beasley, MD
• Chelsea Bennett, OTD
• Janis Benson
• Steffany Calloway Benton, DNP, APRN, FNP-BC
• Aaron Patrick Best, MD
• Bethel Burris Oliver PLLC (Arkansas Dentistry and Braces)
• Maggie Bethell, APRN-CNP
• Billingsley Therapy Services, LLC
• Amber Leigh Billingsley, OTR

• General Practice Dentistry in Forrest City, AR
• Providers in Forrest City, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.