Tanya P Berg, D.M.D
Individual provider Active NPI General Practice Dentistry · Cheyenne, WY
NPI 1659685113 · NPPES record last updated Aug 31, 2022
Key facts
- NPI
- 1659685113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 10240 (CO)
- Practice address
- 6900 Alden Dr
Cheyenne, WY 82005-2945 - Phone
- (307) 773-5624
- NPI assigned
- Jul 27, 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 |
|---|---|---|---|
| 10240 | CO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10240 | CO | Yes |
Addresses
Primary practice location
6900 Alden Dr
Cheyenne, WY 82005-2945
Mailing address
6900 Alden Dr
Cheyenne, WY 82005-2945
Phone (307) 773-5624
Other providers in Cheyenne, WY
- Margret Bennett
- Matthew Quinn Benson
- Susan Lorraine Bentley
- Benview Care
- Douglas Berg
- Andree Bergeron
- Jessica Sherie Bergholz
- Nancy Bergquist
- Christopher Berry
- Kati Bertolini
All providers in Cheyenne, WY · General Practice Dentistry in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2022. 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.