Laura Ellen Berger, DDS
Individual provider Active NPI Dentist · Wallingford, CT
NPI 1487955076 · NPPES record last updated Nov 12, 2010
Key facts
- NPI
- 1487955076
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 007819 (CT)
- Practice address
- 85 Barnes Rd
Suite 207
Wallingford, CT 06492-1832 - Phone
- (203) 678-1201
- Fax
- (203) 678-1209
- NPI assigned
- Nov 12, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007819 | CT | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 007819 | CT | Yes |
Addresses
Primary practice location
85 Barnes Rd
Suite 207
Wallingford, CT 06492-1832
Mailing address
25 Needham St
Newton, MA 02461-1615
Phone (617) 964-6681
Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.