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General NPI Number Information
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NPI Number | 1346258514
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE DENTAL GROUP IV
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2001 PALMER AVENUE
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City | LARCHMONT
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State | NY
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Zip | 10538
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Country | US
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Telephone | 914-834-0220
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Fax | 914-834-7933
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Provider Business Mailing Address
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Address Line | 2001 PALMER AVENUE
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City | LARCHMONT
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State | NY
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Zip | 10538
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Country | US
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Telephone | 914-834-0220
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Fax | 914-834-7933
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Authorized Official
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Title or Position | DENTIST/PARTNER
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Name | DR. IRA A BERMAN
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Credential | DMD
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Telephone | 914-834-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 045822
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 030264
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 043808
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License Number State | NY
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