Individual provider Active NPI

Jeffrey Noble Berndt, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chapel Hill, NC
National Provider Identifier
1417043605
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
8899 Issued in NC
Practice address
121 S Estes Dr
Chapel Hill, NC 27514-2868
Phone
(919) 933-3310
NPI assigned
Oct 5, 2006
Last updated
Aug 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 8899 NC Primary

Addresses

Primary practice location

121 S Estes Dr
Chapel Hill, NC 27514-2868

Mailing address

121 S Estes Dr
Chapel Hill, NC 27514-2868
Phone (919) 933-3310

Other identifiers 4

IdentifierTypeStateIssuer
5031380MedicaidWA
125277OtherWAL & I
5031380OtherWACHPW
911019392OtherCOMMERCIAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8899NCMDSports Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1417043605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S ESTES DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142868",
            "telephone_number": "919-933-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S ESTES DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142868",
            "telephone_number": "919-933-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNDT",
        "first_name": "JEFFREY",
        "middle_name": "NOBLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "8899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5031380",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "125277",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHPW",
            "identifier": "5031380",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "911019392",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.