Individual provider Active NPI

Bernard Mario Sarkis, DMD

  • Dentist
  • San Mateo, CA
National Provider Identifier
1770100372
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107219 Issued in CA
Practice address
100 S Ellsworth Ave Ste 601
San Mateo, CA 94401-3928
Phone
(650) 342-9941
NPI assigned
Jun 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1858718 MA
Dentist 122300000X 107219 CA Primary

Addresses

Primary practice location

100 S Ellsworth Ave Ste 601
San Mateo, CA 94401-3928

Mailing address

1471 High St
Westwood, MA 02090-3026
Phone (617) 763-3394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20250107001727 MA Practitioner - Dentist 4486182250 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107219CAMDDentist
DN1858718MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Harbor Health Services Inc CurrentSince Jan 1, 2025 Accepting new patients
Harbor Health Services, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Sylvie M Galerneau, DMD Dentist PastSince Jul 24, 2022 Accepting new patients

Locations

250 Mount Vernon St
Dorchester, MA 02125
Phone (617) 288-1140

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

516 Route 134
Ste 12
South Dennis, MA 02660
Phone (508) 430-7710

Interoperability endpoints

  • Direct secure messaging: bsarkis762427@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1770100372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 HIGH ST",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020903026",
            "telephone_number": "617-763-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE STE 601",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013928",
            "telephone_number": "650-342-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARKIS",
        "first_name": "BERNARD",
        "middle_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858718",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.