NPIMap

Organization Active NPI

Dorothea J Berry DDS, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • San Juan Capistrano, CA
National Provider Identifier
1659861425
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
52968 Issued in CA
Legal business name
DOROTHEA J BERRY DDS, INC
Doing business as
SUNCOAST ORAL SURGERY
Practice address
27462 Calle Arroyo Ste 46B
San Juan Capistrano, CA 92675-6762
Phone
(562) 240-3054
Fax
(562) 317-5260
NPI assigned
May 16, 2018
Organization subpart
Yes
Parent organization
DOROTHEA J BERRY DDS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Authorized official

Name
Dr. Dorothea Berry, DDSNPI 1851451108
Title
Omfs
Phone
(562) 240-3054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 52968 CA Primary

Addresses

Primary practice location

27462 Calle Arroyo Ste 46B
San Juan Capistrano, CA 92675-6762

Mailing address

2690 Pacific Ave Ste 250
Long Beach, CA 90806-2663
Phone (562) 240-3054

Other names 1

  • SUNCOAST ORAL SURGERY Doing business as

National Provider Directory

National Provider Directory
Part of
Dorothea J Berry DDS Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1659861425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 PACIFIC AVE STE 250",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062663",
            "telephone_number": "562-240-3054",
            "fax_number": "562-317-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27462 CALLE ARROYO STE 46B",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926756762",
            "telephone_number": "562-240-3054",
            "fax_number": "562-317-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOROTHEA J BERRY DDS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOROTHEA J BERRY DDS, INC",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DOROTHEA",
        "authorized_official_title_or_position": "OMFS",
        "authorized_official_telephone_number": "562-240-3054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "52968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNCOAST ORAL SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.