Active NPI
Berous Lane Parish, D.D.S.
- Dentist
- Benicia, CA
National Provider Identifier
1952499170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33507
- Practice address
- 175 E N St
Benicia, CA 94510-2728 - Phone
- (707) 745-8264
- Fax
- (707) 745-1959
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 33507 | CA | Primary |
Addresses
Primary practice location
175 E N St
Benicia, CA 94510-2728
Mailing address
175 E N St
Benicia, CA 94510-2728
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33507 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410393600000",
"number": "1952499170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 E N ST",
"city": "BENICIA",
"state": "CA",
"postal_code": "945102728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 E N ST",
"city": "BENICIA",
"state": "CA",
"postal_code": "945102728",
"telephone_number": "707-745-8264",
"fax_number": "707-745-1959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARISH",
"first_name": "BEROUS",
"middle_name": "LANE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2014-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "33507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benicia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.