Samuel Jay Berngard, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

O12O74 Issued in MI

Practice address

1729 E Saginaw St
Lansing, MI 48912-2324

Phone

(517) 484-2400

Fax

(517) 484-5210

NPI assigned

Dec 18, 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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407919103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 E SAGINAW ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122324",
            "telephone_number": "517-484-2400",
            "fax_number": "517-484-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 E SAGINAW ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122324",
            "telephone_number": "517-484-2400",
            "fax_number": "517-484-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNGARD",
        "first_name": "SAMUEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "O12O74",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward D Berg
• Nikki Bergman
• Billie Sue Berman, N.P.
• Sha'Nae M Bernard
• Ashley Bernardino
• Brandi Joy Berry, LLMSW
• Paula Berry, REGISTERED NURSE
• Alexander John Berthusen, DO
• Barbara Elaine Berti, PH.D.
• Sara Elizabeth Berti, PA-C

• Endodontics in Lansing, MI
• Providers in Lansing, MI by specialty
• Endodontics in Michigan

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.