MEDICARE: BERRY FAMILY DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1710847496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERRY FAMILY DENTAL PLLC

Provider Business Mailing Address
First Line	:	9250 ALBUS HILLS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-1232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6525 N BUFFALO DR STE 180
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4078
Country	:	US
Telephone Number	:	702-256-8000
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	GARRETT BERRY
Credential	:	DMD
Telephone Number	:	702-528-1333

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	11/14/2025

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