Christian Sven Berdy I, DDS,MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN 5959 Issued in FL

Practice address

1511 Stockton St
Jacksonville, FL 32204-4521

Phone

(904) 389-1376

Fax

(904) 386-1522

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 17, 2021 through Feb 17, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Berdy Dental Group

  • Periodontics
  • Jacksonville, FL
  • NPI 1851433510
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396765889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 STOCKTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044521",
            "telephone_number": "904-389-1376",
            "fax_number": "904-386-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 STOCKTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044521",
            "telephone_number": "904-389-1376",
            "fax_number": "904-386-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDY",
        "first_name": "CHRISTIAN",
        "middle_name": "SVEN",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN 5959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benzer FL 6 LLC
• Pia Benzer, APRN
• Fatjona Berati
• Berdy Dental Group
• Cary Stephen Berdy, D.D.S.
• Igor Berengolts, MD
• Dawn Berg, BCABA
• Kristin Marie Berg
• Alan Ross Berger, MD
• Amelia Berger

• Periodontics in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.