MEDICARE: BERKDAR DENTAL PC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1245108026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERKDAR DENTAL PC

Provider Business Mailing Address
First Line	:	15 MAREBLU STE 280
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3068
Country	:	US
Telephone Number	:	949-487-9220
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 MAREBLU STE 280
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3068
Country	:	US
Telephone Number	:	949-487-9220
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AHD BERKDAR
Credential	:	DDS
Telephone Number	:	714-797-3966

Provider Enumeration Date	:	10/24/2025
Last Update Date	:	10/24/2025

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Directions to “BERKDAR DENTAL PC ” Practice Location

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