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NPI Code Detail

MEDICARE: DR. JEFFREY BERNARDY D.D.S.

MEDICARE: DR. JEFFREY BERNARDY D.D.S.
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
11223G0001XGeneral Practice DentistryD008299AZ

General Provider Information

NPI Number : 1316081714
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY BERNARDY D.D.S.
Provider Business Mailing Address
First Line : 1 E LEXINGTON AVE UNIT 901
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2489
Country : US
Telephone Number : 303-809-2964
Fax Number :
Provider Business Practice Location Address
First Line : 1130 S COUNTRY CLUB DR UNIT 101
Second Line :
City : MESA
State : AZ
Zip : 85210-4639
Country : US
Telephone Number : 480-833-9866
Fax Number : 480-461-9861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2007
Last Update Date : 09/12/2011

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