Individual provider Active NPI

Michael Ellis Berglass, DDS

  • Dentist
  • Boynton Beach, FL
National Provider Identifier
1457425787
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN17207 Issued in FL
Practice address
650 W Boynton Beach Blvd
Suite 2
Boynton Beach, FL 33426
Phone
(561) 736-1700
Fax
(561) 738-1961
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8140 NC
Dentist 122300000X DN17207 FL Primary

Addresses

Primary practice location

650 W Boynton Beach Blvd
Suite 2
Boynton Beach, FL 33426

Mailing address

650 W Boynton Beach Blvd
Suite 2
Boynton Beach, FL 33426
Phone (561) 736-1700

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
8140NCMDProfessional Counselor
DN17207FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Berglass, DDS PLLC General Practice Current Accepting new patients
Michael Berglass, DDS, PLLC General Practice Current Accepting new patients
Charles T Bobo DMD PLLC General Practice Past Accepting new patients

Locations

2415 Quantum Blvd
Boynton Beach, FL 33426
Phone (561) 736-1700

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1457425787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W BOYNTON BEACH BLVD",
            "address_2": "SUITE 2",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "561-736-1700",
            "fax_number": "561-738-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W BOYNTON BEACH BLVD",
            "address_2": "SUITE 2",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "561-736-1700",
            "fax_number": "561-738-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLASS",
        "first_name": "MICHAEL",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8140",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN17207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.