Donald Jay Berquist Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019032682 Issued in IL

Practice address

3009 E 92ND St
Chicago, IL 60617-4598

Phone

(773) 295-2521

NPI assigned

Oct 10, 2020

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Dental Care

  • Public Health Dentistry
  • Chicago, IL
  • NPI 1306514773
  NPD

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

{
    "created_epoch": "1602288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602288000000",
    "number": "1699373829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 LONGFELLOW DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480854817",
            "telephone_number": "248-672-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 E 92ND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174598",
            "telephone_number": "773-295-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERQUIST",
        "first_name": "DONALD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-10",
        "last_updated": "2020-10-10",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019032682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Bernstein, MD
• Sean I Bernstein
• Sherry L. Bernstein
• Victor J Bernstein, PH.D.
• Genevieve Beronilla Ramos, LPC
• Madalin Rose Berra
• Amy M. Berrafato, LMFT
• Jamie Berray
• Vanessa Berrettini
• Bernadine Espiritu Berridge, MD

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2020; 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.