1447343991 NPI number — DR. CAROLINE BERMAN DMD, PA

Table of content: AMNA KHALID M.D. (NPI 1417708819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447343991 NPI number — DR. CAROLINE BERMAN DMD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERMAN
Provider First Name:
CAROLINE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD, PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GONZALEZ
Provider Other First Name:
CAROLINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447343991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 12TH STREET NW SUITE L-300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-783-3368
Provider Business Mailing Address Fax Number:
202-783-3361

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 12TH STREET NW SUITE L-300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-783-3368
Provider Business Practice Location Address Fax Number:
202-783-3361
Provider Enumeration Date:
10/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DEN1000573 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 122300000X , with the licence number: DN16895 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)