Healthcare Provider Details

I. General information

NPI: 1225226335
Provider Name (Legal Business Name): ANDREW BERMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 MARNE HWY STE 103
MOORESTOWN NJ
08057-3126
US

IV. Provider business mailing address

740 MARNE HWY STE 103
MOORESTOWN NJ
08057-3126
US

V. Phone/Fax

Practice location:
  • Phone: 856-638-1234
  • Fax:
Mailing address:
  • Phone: 856-638-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number22DIO2352100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: