Al Ira Berger, DDS
Individual provider Active NPI General Practice Dentistry · Oakdale, NY
NPI 1992713853 · NPPES record last updated Jul 14, 2014
Key facts
- NPI
- 1992713853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- O33640 (NY)
- Practice address
- 755 Montauk Highway
Suite 1
Oakdale, NY 11769 - Phone
- (631) 589-2600
- Fax
- (631) 589-2845
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150626001599 | NY | Order and Referring Only - Oral Surgery |
6507178928 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O33640 | NY | MD | General Practice Dentistry |
| 033640 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | O33640 | NY | Yes |
Addresses
Primary practice location
755 Montauk Highway
Suite 1
Oakdale, NY 11769
Mailing address
755 Montauk Highway
Suite 1
Oakdale, NY 11769
Phone (631) 589-2600
Other providers in Oakdale, NY
- Amy Buckley LCSW
- Kelly Ann Andriano
- Danielle Ashby
- Salil Bakshi
- Mary Ann Beatty
- Jared Ross Beyer
- Roberta Biancuzzo Staebler
- Brandon Bjertnes
- Patricia Blanco
- Amanda R Bloom
All providers in Oakdale, NY · General Practice Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.