Steven L Berke, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

006728 Issued in CT

Practice address

130 New London Tpke
Norwich, CT 06360-2624

Phone

(860) 886-0651

Fax

(860) 823-1577

NPI assigned

Sep 12, 2005

Last updated

Sep 30, 2013By 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 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• GM Surgical Associates LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Norwich, CT
  • NPI 1912428160
  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1275527772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NEW LONDON TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602624",
            "telephone_number": "860-886-0651",
            "fax_number": "860-823-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NEW LONDON TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602624",
            "telephone_number": "860-886-0651",
            "fax_number": "860-823-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKE",
        "first_name": "STEVEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CT",
            "license": "006728",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "006728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER ID #",
            "identifier": "020006728CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "190000670",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004083333",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA MEDICAL PROVIDER ID",
            "identifier": "5477144",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Banks Belt, PT
• Victoria Lou Bensko, APRN
• Bentley Therapy
• Melissa Jo Bergeron, RN., CRNFA
• Melissa Bergfeld, APRN
• Gail W Bettencourt, CRNA
• Better Bee Therapy and Wellness LLC
• Aakash Bhargava, MD
• Paras Satish Bhatt, MD
• Unknown Bhawna, M.B.B.S

• Oral and Maxillofacial Surgery (Dentist) in Norwich, CT
• Providers in Norwich, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.