Individual provider Active NPI

Jared Ian Berger, DMD

  • General Practice Dentistry
  • Brick, NJ
National Provider Identifier
1821100595
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI02172700 Issued in NJ
Practice address
35 Beaverson Blvd Ste 3B
Brick, NJ 08723-7856
Phone
(732) 920-7700
Fax
(732) 920-7701
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI02172700 NJ Primary

Addresses

Primary practice location

35 Beaverson Blvd Ste 3B
Brick, NJ 08723-7856

Mailing address

35 Beaverson Blvd
Ste 3B
Brick, NJ 08723-7812
Phone (732) 920-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150522000303 NJ Order and Referring Only - DentistPractitioner - Dentist 2668792284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI02172700NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dentistry of Brick P.a. Past Accepting new patients

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1821100595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BEAVERSON BLVD",
            "address_2": "STE 3B",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237812",
            "telephone_number": "732-920-7700",
            "fax_number": "732-920-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BEAVERSON BLVD STE 3B",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237856",
            "telephone_number": "732-920-7700",
            "fax_number": "732-920-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "JARED",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI02172700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.