NPIMap

Organization Active NPI

Berry Children Dental of Bowie

  • Dentist
  • Bowie, MD
National Provider Identifier
1891186151
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13338 Issued in MD
Legal business name
BERRY CHILDREN DENTAL OF BOWIE
Practice address
4449 Mitchellville Rd
Bowie, MD 20716-3169
Phone
(301) 383-0959
Fax
(240) 334-2107
NPI assigned
Feb 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Authorized official

Name
Mrs. Terry Rodgers
Title
Pracrice Administrator
Phone
(307) 383-0959

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 13338 MD Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 15002 MD
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 14110 MD
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 15191 MD
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 13602 MD

Addresses

Primary practice location

4449 Mitchellville Rd
Bowie, MD 20716-3169

Mailing address

4449 Mitchellville Rd
Bowie, MD 20716-3169
Phone (301) 383-0959

National Provider Directory

National Provider Directory

Locations

4449 Mitchellville Rd
Mitchellville, MD 20716
Phone (301) 333-2282

Practitioners & affiliated clinicians

Practitioners 3

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": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1891186151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4449 MITCHELLVILLE RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163169",
            "telephone_number": "301-383-0959",
            "fax_number": "240-334-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4449 MITCHELLVILLE RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163169",
            "telephone_number": "301-383-0959",
            "fax_number": "240-334-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRY CHILDREN DENTAL OF BOWIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRACRICE ADMINISTRATOR",
        "authorized_official_telephone_number": "307-383-0959",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13338",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "15002",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "14110",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "15191",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.