Jordan Anthony Berry, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8800 Issued in SC

Practice address

675 Wachesaw Rd Unit C
Murrells Inlet, SC 29576-5681

Phone

(843) 230-7495

NPI assigned

Mar 7, 2016

Last updated

Apr 25, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1588025324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 GRAY HERON DR",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295829547",
            "telephone_number": "843-230-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 WACHESAW RD UNIT C",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765681",
            "telephone_number": "843-230-7495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Sycamore Ave Apt 111",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294076713",
            "country_code": "US",
            "telephone_number": "843-230-7495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JORDAN",
        "middle_name": "ANTHONY",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-07",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben P Clark OD PA
• Ben P. Clark, OD PA
• Benchmark Health Services, LLC
• Stephanie Benton, MSN, PMHNP, RN
• Laura Anne Bernard, PHARMD
• Benjamin Paul Berteau, MD
• BFG Compass Murrells Inlet Propco, LLC (Magnolia Bridge at Murrells Inlet)
• Cynthia Givens Bindner, MD
• Bio-Medical Applications of South Carolina, Inc. (FMC Dialysis Services Murrells Inlet)
• Richard Michael Birch Jr., DMD

• General Practice Dentistry in Murrells Inlet, SC
• Providers in Murrells Inlet, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.