MEDICARE: BERKE DENTAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	015925	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184708026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERKE DENTAL CENTER

Provider Business Mailing Address
First Line	:	2460 FAIRMOUNT BLVD
Second Line	:	SUITE 218
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3171
Country	:	US
Telephone Number	:	216-791-5191
Fax Number	:	216-231-4933

Provider Business Practice Location Address
First Line	:	2460 FAIRMOUNT BLVD
Second Line	:	SUITE 218
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44106-3171
Country	:	US
Telephone Number	:	216-791-5191
Fax Number	:	216-231-4933

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT ALAN SHAPIRO
Credential	:	D.D.S.
Telephone Number	:	216-791-5191

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

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Directions to “BERKE DENTAL CENTER ” Practice Location

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