Individual provider Active NPI

Carol Ann Berg, D.D.S

  • Dentist
  • Rancho Mirage, CA
National Provider Identifier
1912194663
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32449 Issued in CA
Practice address
72027 Desert Dr
Ste. 100
Rancho Mirage, CA 92270-4959
Phone
(760) 776-5025
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 32449 CA Primary

Addresses

Primary practice location

72027 Desert Dr
Ste. 100
Rancho Mirage, CA 92270-4959

Mailing address

72027 Desert Dr
Ste. 100
Rancho Mirage, CA 92270-4959
Phone (760) 776-5025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
32449CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1912194663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72027 DESERT DR",
            "address_2": "STE. 100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704959",
            "telephone_number": "760-776-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72027 DESERT DR",
            "address_2": "STE. 100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704959",
            "telephone_number": "760-776-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "32449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.