Sky Ashley Berdahl, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

053590 Issued in NY

Practice address

485 1St Ave Apt 5T
New York, NY 10016-8627

Phone

(917) 406-3773

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1376764084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 PELHAM PKWY N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104696416",
            "telephone_number": "917-406-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 1ST AVE APT 5T",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168627",
            "telephone_number": "917-406-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDAHL",
        "first_name": "SKY",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "P44160",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "053590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria-Pilar Berbery, M.D.
• Amy Berbiglia
• Kenneth Berc, M.D.
• Sarah T Bercovitz
• Eloise Berdahl-Baldwin
• Maria Berdella, M.D.
• Hagit Berdishevsky
• Russell Lindsay Berdoff, MD
• Michael Berelowitz, MD
• Phyllis Beren, PH.D.

• Pediatric Dentistry in New York, NY
• Providers in New York, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.