Dr. Kenneth Richard Berg , DMD
Dentist - General Practice • Portland, OR
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kenneth Berg has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Kenneth Berg, DMD was a registered Dentist - General Practice practicing in Portland, OR. Throughout an active medical career spanning 9 years, Dr. Berg provided care at the practice location at 3550 SW BOND AVE until profile deactivation on 2024-11-21.
Practice Location & Contact Primary Location
3550 Sw Bond Ave
Portland, OR 972394507
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Portland, OR
Practicing in Portland, OR (1994 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Occupational Therapy Assistant
Certified Occupational Therapy Assistant, L
Physical Therapy Assistant
Physical Therapist Assistant
Audiologist
Physical Therapist
Physical Therapist
Physical Therapist
Doctor of Physical Therapy
Occupational Therapy Assistant
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on November 21, 2024
NPI status registered as active in NPPES database
Registered at 3550 SW BOND AVE, PORTLAND, OR 972394507 (Tel: 5036886719)
Registered at 3550 SW BOND AVE, PORTLAND, OR 972394507 (Tel: 5036886719)
Recorded as KENNETH BERG, DMD
Dentist (License #D3208 in OR)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
3550 Sw Bond Ave
Portland, OR 972394507
Phone: 5036886719
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