Provider Demographics
NPI:1396087284
Name:BERRYHILL, KRISTA LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:LYNN
Last Name:BERRYHILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:968 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6606
Mailing Address - Country:US
Mailing Address - Phone:563-556-3468
Mailing Address - Fax:
Practice Address - Street 1:968 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6606
Practice Address - Country:US
Practice Address - Phone:563-556-3468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190318511223G0001X
IA77961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice