1407278062 NPI number — BIERMAN AND MA DENTAL PARTNERSHIP A GENERAL PARTNERSHIP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407278062 NPI number — BIERMAN AND MA DENTAL PARTNERSHIP A GENERAL PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIERMAN AND MA DENTAL PARTNERSHIP A GENERAL PARTNERSHIP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407278062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6635 FLANDERS DR STE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92121-2978
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-457-4100
Provider Business Mailing Address Fax Number:
858-457-5200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6635 FLANDERS DR STE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92121-2978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-457-4100
Provider Business Practice Location Address Fax Number:
858-457-5200
Provider Enumeration Date:
01/15/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BIERMAN
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
FRANK
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
703-975-0257

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  62967 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 62908 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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