Active NPI
Jeremy Scott Berger, D.D.S.
- Dentist
- Red Wing, MN
National Provider Identifier
1710334644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D13692
- Practice address
- 424 W 5TH St # 1
Red Wing, MN 55066-2524 - Phone
- (651) 388-5492
- NPI assigned
- May 20, 2016
- Last updated
- May 19, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D13692 | MN | Primary |
Addresses
Primary practice location
424 W 5TH St # 1
Red Wing, MN 55066-2524
Mailing address
424 W 5TH St # 1
Red Wing, MN 55066-2524
Phone (651) 388-5492
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D13692 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeremy Berger DDS PLLC | Current | Accepting new patients | |
| Sibley Dental Suite, PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Litchfield, MN
- NPI 1780738179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1710334644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 W 5TH ST # 1",
"city": "RED WING",
"state": "MN",
"postal_code": "550662524",
"telephone_number": "651-388-5492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 W 5TH ST # 1",
"city": "RED WING",
"state": "MN",
"postal_code": "550662524",
"telephone_number": "651-388-5492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGER",
"first_name": "JEREMY",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-20",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Wing, MN
- Benedictine Care Centers (St. Brigid's at Hi-Park)
- Benedictine Care Centers
- Benedictine Care Centers (St. Crispin Living Community - The Villa)
- Jeri Lynn Benser, RN
- Brian R Bergan, DDS
- Sarah Joy Berhow, APRN, CNP
- Marc E Bettich, MD
- Bikes for Everybody LLC
- Bill Clafton PSYD LP LLC
- Brian David Billing, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.