DR. KENNETH MOSES BERO JR. (NPI# 1871723395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871723395 |
| Entity Type | Individual |
| Full Name | DR. KENNETH MOSES BERO JR. |
| Credential | DDS |
| Practice Address |
533 South Main St. The Gentle Dental Emporium LLC West Bend WI 53095 |
| Mailing Address |
533 South Main St The Gentle Dental Emporium LLC West Bend WI 53095 |
| Practice Telephone | 2623388704 |
| Practice Fax Number | 2623389140 |
| Mailing Telephone | 2623388704 |
| Mailing Fax Number | 2623389140 |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | WI2517K | WI | Dental Providers |
| Street Address |
533 SOUTH MAIN ST. THE GENTLE DENTAL EMPORIUM LLC |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033349956 | Kristine Kim Neuburg | Dentist | 533 South Main St., The Gentle Dental Emporium LLC, West Bend, WI 53095 | 2009-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497294722 | Mdc West Bend, LLC | Dentist | 1625 W Paradise Dr, West Bend, WI 53095-7846 | 2017-02-20 |
| 1649492208 | Paradise Dental Professionals S.c. | Dentist | 1625 W Paradise Drive, West Bend, WI 53095 | 2007-05-03 |
| 1891916573 | David C Hammer | Dentist | 1625 W. Paradise Drive, West Bend, WI 53095 | 2007-05-01 |
| 1457492282 | Barton Dental Clinic Sc | Dentist | 1542 Barton Ave, West Bend, WI 53090 | 2007-02-12 |
| 1184760894 | Christopher Allan Buck | Dentist | 1713 N Main Street, West Bend, WI 53090 | 2007-01-29 |
| 1154477818 | The Gentle Dental Emporium LLC | Dentist | 533 South Main Street, West Bend, WI 53095 | 2007-01-26 |
| 1588730980 | David R Markovich | Dentist | 1500 South Main Street, West Bend, WI 53095 | 2006-11-28 |
| 1740353390 | Arthur Rex Simonsen | Dentist | 1201 Oak St Ste P, West Bend, WI 53095-3800 | 2006-11-15 |
| 1073690525 | Kent Alan Zocher | Dentist | 1500 South Main St, West Bend, WI 53095 | 2006-11-01 |
| 1497370829 | Leah Marie Fax | Dentist | 309 N 7th Ave, West Bend, WI 53095-3242 | 2020-06-11 |
| Find all providers in WEST BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.