NPIMap

Organization Active NPI

Berro Dental Group

  • Dental Clinic/Center
  • Lincoln Park, MI
National Provider Identifier
1285884734
Registry record updated Sep 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2901019129 Issued in MI
Legal business name
BERRO DENTAL GROUP
Practice address
1193 Southfield Rd
Lincoln Park, MI 48146-2450
Phone
(313) 388-1800
Fax
(313) 388-5527
NPI assigned
Sep 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2008

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

Authorized official

Name
Dr. Abbas Hussein Berro, DDSNPI 1366489452
Title
Dentist/President
Phone
(313) 388-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2901019129 MI Primary

Addresses

Primary practice location

1193 Southfield Rd
Lincoln Park, MI 48146-2450

Mailing address

1193 Southfield Rd
Lincoln Park, MI 48146-2450
Phone (313) 388-1800

Other identifiers 1

IdentifierTypeStateIssuer
4979625MedicaidMI

Other names 1

  • Kennedy Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1193 Southfield Rd
Lincoln Park, MI 48146
Phone (313) 388-1800

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222041600000",
    "number": "1285884734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193 SOUTHFIELD RD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462450",
            "telephone_number": "313-388-1800",
            "fax_number": "313-388-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 SOUTHFIELD RD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462450",
            "telephone_number": "313-388-1800",
            "fax_number": "313-388-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRO DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2008-09-22",
        "status": "A",
        "authorized_official_last_name": "BERRO",
        "authorized_official_first_name": "ABBAS",
        "authorized_official_middle_name": "HUSSEIN",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "313-388-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901019129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4979625",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; 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.