Individual provider Active NPI

Tyler H. Berkey, DMD

  • General Practice Dentistry
  • Park Falls, WI
National Provider Identifier
1386922870
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6776 Issued in WI
Practice address
75 Sherry Ave
Park Falls, WI 54552-1468
Phone
(715) 762-0200
NPI assigned
Aug 1, 2011
Last updated
Aug 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6776 WI Primary

Addresses

Primary practice location

75 Sherry Ave
Park Falls, WI 54552-1468

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20120626000440 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3375708332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6776WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Godent PLLC Current Accepting new patients
Family Health Center of Marshfield Inc PastSince May 28, 2023 Accepting new patients
Family Health Center of Marshfield Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1386922870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SHERRY AVE",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521468",
            "telephone_number": "715-762-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKEY",
        "first_name": "TYLER",
        "middle_name": "H.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Falls, WI

Sources for this page

Verify at the official NPI Registry.