NPIMap

Organization Active NPI

Berks Oral Surgery LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Wyomissing, PA
National Provider Identifier
1790710325
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS-017990-L Issued in PA
Legal business name
BERKS ORAL SURGERY LTD
Practice address
1075 Berkshire Blvd
Suite 800
Wyomissing, PA 19610-1264
Phone
(610) 374-4093
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Mrs. Robin Lynn Bast
Title
Office Manager
Phone
(610) 374-4093

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X DS026002-L PA
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X DS024152-L PA
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X DS-017990-L PA Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X DS-017170-L PA

Addresses

Primary practice location

1075 Berkshire Blvd
Suite 800
Wyomissing, PA 19610-1264

Mailing address

1075 Berkshire Blvd
Suite 800
Wyomissing, PA 19610-1264
Phone (610) 374-4093

National Provider Directory

National Provider Directory

Locations

427 Windsor St
Hamburg, PA 19526
Phone (484) 665-3977

5001 Perkiomen Ave
Ste 100
Reading, PA 19606
Phone (610) 373-2300

1075 Berkshire Blvd
Ste 800
Wyomissing, PA 19610
Phone (610) 374-4093

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1790710325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 BERKSHIRE BLVD",
            "address_2": "SUITE 800",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101264",
            "telephone_number": "610-374-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BERKSHIRE BLVD",
            "address_2": "SUITE 800",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101264",
            "telephone_number": "610-374-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKS ORAL SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "BAST",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-374-4093",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS026002-L",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS024152-L",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS-017990-L",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS-017170-L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.