Keith R Berg, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4310 Issued in OR

Practice address

2936 E Barnett Rd
Medford, OR 97504-8309

Phone

(541) 779-4517

Fax

(541) 779-4605

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• James K Johnson DMD, LLC

  • Dentist
  • Medford, OR
  • NPI 1275839110
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811021934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048309",
            "telephone_number": "541-779-4517",
            "fax_number": "541-779-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 E BARNETT RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048309",
            "telephone_number": "541-779-4517",
            "fax_number": "541-779-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "KEITH",
        "middle_name": "R",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D4310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Bentley
• Daniel J Bentley, PA
• Melody Kauilani Bentley, MS
• Jonathan Cash Beran, OTR/L
• Hailey Breanne Berg
• Lora J Bergert, MD
• Cory Bergey, DO
• Sophia Catherine Bergum
• Brandon Berioso, PHARMD
• James Zheng Berking, PA-C

• General Practice Dentistry in Medford, OR
• Providers in Medford, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.