Paul Eugene Berg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9162 Issued in MN

Practice address

6519 Nicollet Ave S
#205
Richfield, MN 55423-1669

Phone

(612) 861-7141

NPI assigned

Jan 3, 2006

Last updated

Jun 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1720066517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6519 NICOLLET AVE S",
            "address_2": "#205",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231669",
            "telephone_number": "612-861-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6519 NICOLLET AVE S",
            "address_2": "#205",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231669",
            "telephone_number": "612-861-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "PAUL",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Benish, PA
• Amber Brooke Benson, FNP-BC
• Monique Benson
• Rebecca Leigh Benson, D.D.S.
• Gretchen Kativa Berg
• Brock WR Bergman, DPT
• Daniel G. Beyers, LMFT
• Chris Bezenson, LMFT
• Joyce Biddle
• Sydney Marie Biel, OTR

• General Practice Dentistry in Richfield, MN
• Providers in Richfield, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.