Healthcare Provider Details

I. General information

NPI: 1083134324
Provider Name (Legal Business Name): RABECCA BERLINSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RABECCA VANEVENHOVEN

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14955 SHADY GROVE RD STE 330
ROCKVILLE MD
20850-8720
US

IV. Provider business mailing address

14955 SHADY GROVE RD STE 330
ROCKVILLE MD
20850-8720
US

V. Phone/Fax

Practice location:
  • Phone: 301-241-6819
  • Fax:
Mailing address:
  • Phone: 301-241-6819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number17578
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0438000444
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: