Organization Active NPI

John a. Berchelmann Jr., DDS

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1750627212
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
B16811 Issued in TX
Legal business name
JOHN A. BERCHELMANN JR., DDS
Practice address
608 Fair Ave
San Antonio, TX 78223-1304
Phone
(210) 534-8051
Fax
(210) 532-2761
NPI assigned
Jan 2, 2013
Last updated
Jan 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Authorized official

Name
Dr. John Anthony Berchelmann Jr., DDSNPI 1255445318
Title
Owner
Phone
(210) 534-8051

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X B12916 TX
General Practice Dentistry 1223G0001X B16811 TX Primary

Addresses

Primary practice location

608 Fair Ave
San Antonio, TX 78223-1304

Mailing address

608 Fair Ave
San Antonio, TX 78223-1304
Phone (210) 534-8051

Other identifiers 1

IdentifierTypeStateIssuer
1458259-01MedicaidTX

National Provider Directory

National Provider Directory

Locations

608 Fair Ave
San Antonio, TX 78223
Phone (210) 336-8478

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1750627212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 FAIR AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782231304",
            "telephone_number": "210-534-8051",
            "fax_number": "210-532-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 FAIR AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782231304",
            "telephone_number": "210-534-8051",
            "fax_number": "210-532-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A. BERCHELMANN JR., DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-02",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "BERCHELMANN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-534-8051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "B12916",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "B16811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1458259-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.