Active NPI
Donald P De Berry, DDS
- General Practice Dentistry
- Berkeley, CA
National Provider Identifier
1760520258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15204
- Practice address
- 2121 Parker St
Berkeley, CA 94704 - Phone
- (510) 848-2346
- Fax
- (510) 843-8343
- NPI assigned
- Feb 5, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15204 | CA | Primary |
Addresses
Primary practice location
2121 Parker St
Berkeley, CA 94704
Mailing address
2121 Parker St
Berkeley, CA 94704
Phone (510) 848-2346
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 |
|---|---|---|---|
| 15204 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590019200000",
"number": "1760520258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 PARKER ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94704",
"telephone_number": "510-848-2346",
"fax_number": "510-843-8343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 PARKER ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "94704",
"telephone_number": "510-848-2346",
"fax_number": "510-843-8343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE BERRY",
"first_name": "DONALD",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2020-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "15204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.