Bertel Thorwaldsen Perry III, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

038858 Issued in NY

Practice address

12 Main Street
Candor, NY 13743-0071

Phone

(607) 659-4050

Fax

(607) 659-4644

NPI assigned

Oct 24, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922098755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71",
            "city": "CANDOR",
            "state": "NY",
            "postal_code": "137430071",
            "telephone_number": "607-659-4050",
            "fax_number": "607-659-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MAIN STREET",
            "city": "CANDOR",
            "state": "NY",
            "postal_code": "137430071",
            "telephone_number": "607-659-4050",
            "fax_number": "607-659-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "BERTEL",
        "middle_name": "THORWALDSEN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Berdette Jackson, LPN
• Samantha Koncak, M.S., SLP
• Kezia Marshall
• Michael F Murphy, MD
• Karen F. Oakley, RN
• Michelle Rising, NP
• Stephen Cleve Scarseth, NP
• James Skiff, MD
• Iesha Smith
• Casey A Taylor, PA-C

• General Practice Dentistry in Candor, NY
• Providers in Candor, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.