Evan Lyle Berson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-024034-L Issued in PA

Practice address

301 E City Ave
Sutie T2
Bala Cynwyd, PA 19004-1708

Phone

(610) 667-6666

NPI assigned

Sep 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639276355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ANDREW RD",
            "city": "MERION STATION",
            "state": "PA",
            "postal_code": "190661327",
            "telephone_number": "610-667-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E CITY AVE",
            "address_2": "SUTIE T2",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041708",
            "telephone_number": "610-667-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSON",
        "first_name": "EVAN",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-024034-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Bennett-Frankel, OTR/L
• Jacqueline Benoit, OD
• Suzanne K.C. Benser, M.D.
• Stanley Randolph Berger, M.D.
• Brad Bernstein, PSY.D, LPC
• Denise Ziya Berte, PH.D.
• Davita L Bey, PHARMD
• Miryam Biberfeld
• Bradley Richard Biedermann, MMT, MT-BC
• Elisheva Shoshana Bier, MS, CCC-SLP

• General Practice Dentistry in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.