Kerry Alberts, DDS – Dentist in Bridgeport, OH

Key facts

NPI: 1992961957
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 30-022816 (OH)
Practice address: 334 Main St
Bridgeport, OH 43912-1346
Phone: (740) 635-2567
Fax: (740) 635-1976
NPI assigned: Jul 30, 2008
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Charles K. Dematte DDS Inc General Practice Dentistry · Bridgeport, OH · NPI 1801050968

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD
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
I20160531002514	MD	Order and Referring Only - Dentist Practitioner - Dentist	4587954714

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
30-022816	OH	MD	Dentist

Practice roles

Organization	Specialty	Status	New patients
Charles K. Dematte DDS Inc		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	30-022816	OH	Yes

Addresses

Primary practice location

334 Main St
Bridgeport, OH 43912-1346

Mailing address

334 Main St
Bridgeport, OH 43912-1346
Phone (740) 635-2567

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 30, 2008.

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1992961957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "OH",
            "postal_code": "439121346",
            "telephone_number": "740-635-2567",
            "fax_number": "740-635-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "OH",
            "postal_code": "439121346",
            "telephone_number": "740-635-2567",
            "fax_number": "740-635-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBERTS",
        "first_name": "KERRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-022816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, OH

All providers in Bridgeport, OH · Dentist in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2008. 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.

Verify at the official NPI Registry.