Individual provider Active NPI

Steven Berger, DMD

  • Dentist
  • Mesa, AZ
National Provider Identifier
1265033427
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10793 Issued in AZ
Practice address
4996 S Power Rd
Mesa, AZ 85212-3602
Phone
(480) 840-3600
NPI assigned
Nov 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10793 AZ Primary

Addresses

Primary practice location

4996 S Power Rd
Mesa, AZ 85212-3602

Mailing address

4363 S Binary
Mesa, AZ 85212-8779
Phone (253) 310-6513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210219001687 AZ Order and Referring Only - DentistPractitioner - Dentist 3870908007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10793AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooley Station Kids Dentist and Orthodontics, LLP Dentist PastSince Nov 8, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1265033427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4363 S BINARY",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128779",
            "telephone_number": "253-310-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4996 S POWER RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123602",
            "telephone_number": "480-840-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "10793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.