Individual provider Active NPI

Benjamin David Berman, DDS

  • General Practice Dentistry
  • Kenosha, WI
National Provider Identifier
1992569081
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6001405 Issued in WI
Practice address
3600 80TH St
Kenosha, WI 53142-4900
Phone
(262) 697-5444
NPI assigned
Feb 8, 2024
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6001405 WI Primary
General Practice Dentistry 1223G0001X 019.035670 IL

Addresses

Primary practice location

3600 80TH St
Kenosha, WI 53142-4900

Mailing address

3600 80TH St
Kenosha, WI 53142-4900
Phone (262) 697-5444

Other practice location 1

8301 S Holland Rd Ste B
Chicago, IL 60620-1303
Phone (773) 488-2444

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
019.035670ILMDGeneral Practice Dentistry
6001405WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1992569081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 80TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424900",
            "telephone_number": "262-697-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 80TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424900",
            "telephone_number": "262-697-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8301 S Holland Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606201303",
            "country_code": "US",
            "telephone_number": "773-488-2444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001405",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.