Healthcare Provider Details

I. General information

NPI: 1255149019
Provider Name (Legal Business Name): BERGEN GENTLE DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 RIVER RD STE 1
NEW MILFORD NJ
07646-3100
US

IV. Provider business mailing address

12 HODSKIN PL
TENAFLY NJ
07670-2604
US

V. Phone/Fax

Practice location:
  • Phone: 201-836-7166
  • Fax:
Mailing address:
  • Phone: 551-587-3685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SHERWIN CHENG
Title or Position: SOLE MEMBER/OWNER
Credential: DDS
Phone: 551-587-3685