Keith Berry, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

2698 Issued in SC

Practice address

350 Hilton Rd
Suite 201
Myrtle Beach, SC 29572-6623

Phone

(843) 497-3707

Fax

(843) 497-3713

NPI assigned

Feb 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Myrtle Beach Endodontics, LLC

  • Endodontics
  • Myrtle Beach, SC
  • NPI 1679282933
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750355145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HILTON RD",
            "address_2": "SUITE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726623",
            "telephone_number": "843-497-3707",
            "fax_number": "843-497-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HILTON RD",
            "address_2": "SUITE 201",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295726623",
            "telephone_number": "843-497-3707",
            "fax_number": "843-497-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "2698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX2698",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Abigail Benton, FNP-BC
• Sarah Elizabeth Benton
• Bergeron Counseling Services LLC
• Lauren Elizabeth Berkey, DMD
• Jonathan D Bernard, M.D.
• John Bertang, MA, LPC
• Eryn Berube, APRN
• Devin Scott Beson, RN
• McLean Beson, MD
• Quinton O Bessant

• All providers in Myrtle Beach, SC
• Endodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.