Robert David Bernie, DDS

Key facts

NPI

1700967502

Entity type

Individual (NPI type 1)

Primary specialty

Endodontics 1223E0200X

License

33021 (CA)

Practice address

1855 Olympic Blvd
Walnut Creek, CA 94596-5069

Phone

(925) 934-4011

Fax

(925) 934-0851

NPI assigned

Oct 18, 2006

Sex

Male

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700967502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 OLYMPIC BLVD",
            "address_2": "#360",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965069",
            "telephone_number": "925-934-4011",
            "fax_number": "925-934-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 OLYMPIC BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965069",
            "telephone_number": "925-934-4011",
            "fax_number": "925-934-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNIE",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "33021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Walnut Creek, CA · Endodontics in California