NPIMap

Organization Active NPI

G.L. Berry D.D.S., a Dental Corporation

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1710182480
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39969 Issued in CA
Legal business name
G.L. BERRY D.D.S., A DENTAL CORPORATION
Doing business as
Neighborhood Family Dental Practice
Practice address
4655 Cass St
Suite 100
San Diego, CA 92109-2809
Phone
(858) 362-3540
Fax
(858) 362-3544
NPI assigned
Jun 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Authorized official

Name
Dr. Gladys L. Berry, D.D.S.NPI 1396846036
Title
President
Phone
(858) 362-3540

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 39969 CA Primary

Addresses

Primary practice location

4655 Cass St
Suite 100
San Diego, CA 92109-2809

Mailing address

4655 Cass St
Suite 100
San Diego, CA 92109-2809
Phone (858) 362-3540

Other identifiers 3

IdentifierTypeStateIssuer
G98442-01OtherCAHEALTHY FAMILIES
1396846036OtherCATYPE 1 NPI NUMBER
G93297-01OtherCADENTI-CAL

Other names 1

  • Neighborhood Family Dental Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glberrydds a Dental Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1710182480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 CASS ST",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092809",
            "telephone_number": "858-362-3540",
            "fax_number": "858-362-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 CASS ST",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092809",
            "telephone_number": "858-362-3540",
            "fax_number": "858-362-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G.L. BERRY D.D.S., A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-362-3540",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILIES",
            "identifier": "G98442-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI NUMBER",
            "identifier": "1396846036",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G93297-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neighborhood Family Dental Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.