Berke Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BERKE DENTAL CORPORATION

Practice address

701 S Raymond Ave
Suite 4B
Fullerton, CA 92831-5201

Phone

(714) 992-2999

Fax

(714) 992-0759

NPI assigned

Jan 28, 2014

Organization subpart

No

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

Authorized official

Name

Samuel D Berke, DDS

Title

President

Phone

(714) 992-2999

Specialties & licenses 1

Addresses

Other names 1

• GOLDEN AGE DENTAL CARE Doing business as

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1508289489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S RAYMOND AVE",
            "address_2": "SUITE 4B",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928315201",
            "telephone_number": "714-992-2999",
            "fax_number": "714-992-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S RAYMOND AVE",
            "address_2": "SUITE 4B",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928315201",
            "telephone_number": "714-992-2999",
            "fax_number": "714-992-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "BERKE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-992-2999",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOLDEN AGE DENTAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• J Nickolas Berbos
• Leslie Bergado
• Bryan Emmanuel Berges
• David Evan Bergman, DO
• Taylor Bergstedt
• Samuel David Berke, D.D.S.
• Patricia Berkley, RD
• Mary Louise Bermani, MFT
• Ria Marie Bermudez, RRT
• Vanessa Roxanne Bermudez

• General Practice Dentistry in Fullerton, CA
• Providers in Fullerton, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.