Stephen Franklin Bergen, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DI 09831 Issued in NJ

Practice address

1 Colonial Woods Dr
West Orange, NJ 07052-1614

Phone

(973) 325-2221

Fax

(973) 325-2391

NPI assigned

May 18, 2006

Last updated

Feb 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1922051382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COLONIAL WOODS DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521614",
            "telephone_number": "973-325-2271",
            "fax_number": "973-325-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLONIAL WOODS DR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521614",
            "telephone_number": "973-325-2221",
            "fax_number": "973-325-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "STEPHEN",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "028556-1",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "DI 09831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nefeli G Bellos, BCBA
• Barbara Benevento, M.D.
• Anne Marie Benitez, LBA, BCBA
• Sharona Benoff, PHD.
• Howard Martin Berg, MD
• Gary K Berman, MD
• Christopher S Bernal
• Melanie C Bernardes, MD
• Patricia Ann Berran, DPM
• Suzanne Gail Bersch Portnoy, MS, CCC-SLP

• Prosthodontics in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Prosthodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.