NPIMap

Organization Active NPI

Berke Dental Corporation

Doing business as Golden Age Dental Care

  • General Practice Dentistry
  • Fullerton, CA
National Provider Identifier
1508289489
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BERKE DENTAL CORPORATION
Doing business as
Golden Age Dental Care
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
Last updated
Jan 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Authorized official

Name
Samuel D Berke, DDSNPI 1790859072
Title
President
Phone
(714) 992-2999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

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

Mailing address

701 S Raymond Ave
Suite 4B
Fullerton, CA 92831-5201
Phone (714) 992-2999

Other names 1

  • GOLDEN AGE DENTAL CARE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • 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.