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General NPI Number Information
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NPI Number | 1003972936
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Entity Type | Organization
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Legal Business Name | BERKSHIRE FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 4201 MASSACHUSETTS AVE NW STE 1040C
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City | WASHINGTON
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State | DC
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Zip | 20016-6046
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Country | US
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Telephone | 202-244-3902
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Fax | 202-244-6547
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Provider Business Mailing Address
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Address Line | 4201 MASSACHUSETTS AVE NW STE 1040C
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City | WASHINGTON
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State | DC
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Zip | 20016-6046
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Country | US
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Telephone | 202-244-3902
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Fax | 202-244-6547
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Authorized Official
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Title or Position | OWNER
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Name | DR. HASSAN E CHEHAYEB
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Credential | D.D.S.
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Telephone | 202-244-3902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN5316
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License Number State | DC
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