Individual provider Active NPI

Jennifer Ellen Berst, DDS

  • General Practice Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1710074315
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7822 Issued in IA
Practice address
4900 N River Blvd NE
Cedar Rapids, IA 52411
Phone
(319) 247-7008
Fax
(319) 378-0937
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7822 IA Primary

Addresses

Primary practice location

4900 N River Blvd NE
Cedar Rapids, IA 52411

Mailing address

4900 N River Blvd NE
Cedar Rapids, IA 52411
Phone (319) 247-7008

Other identifiers 1

IdentifierTypeStateIssuer
1139766MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001559 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315245735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7822IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Berst Dental PC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710074315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 N RIVER BLVD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52411",
            "telephone_number": "319-247-7008",
            "fax_number": "319-378-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 N RIVER BLVD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52411",
            "telephone_number": "319-247-7008",
            "fax_number": "319-378-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERST",
        "first_name": "JENNIFER",
        "middle_name": "ELLEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1139766",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.