J R Berry DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2380 Issued in AR

Legal business name

J R BERRY DDS PC

Practice address

1220 N Division St
Forrest City, AR 72335-2307

Phone

(870) 633-4219

Fax

(870) 633-4120

NPI assigned

Nov 19, 2009

Organization subpart

No

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

Authorized official

Name

John R Berry, DDSNPI 1255662680

Title

President

Phone

(870) 633-4219

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Russell Berry, D.D.S.

  • General Practice Dentistry
  • Forrest City, AR
  • NPI 1255662680
  NPD (past) Authorized official

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1770811341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N DIVISION ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352307",
            "telephone_number": "870-633-4219",
            "fax_number": "870-633-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N DIVISION ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352307",
            "telephone_number": "870-633-4219",
            "fax_number": "870-633-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J R BERRY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-633-4219",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103180608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Ingle, LPC
• Alton R Irwin, PHD
• Henein T. Iskander
• Nizar Chafik Issa, M.D
• Mattie Ivy, SLP
• Careasha Jackson, PLMSW
• Donnie Jackson, RN
• Josephine Furdge Jackson, APRN
• Marvin L Jackson, MHPP
• James Franks Family Medicine

• General Practice Dentistry in Forrest City, AR
• Providers in Forrest City, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.