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NPI Code Detail

MEDICARE: DR. ALAN LIONEL BERNBACH D.M.D.

MEDICARE: DR. ALAN LIONEL BERNBACH D.M.D.
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
11223P0300XPeriodontics11590MD

General Provider Information

NPI Number : 1356465108
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALAN LIONEL BERNBACH D.M.D.
Provider Business Mailing Address
First Line : 8610 GEORGIA AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-3404
Country : US
Telephone Number : 301-589-2714
Fax Number : 301-589-3828
Provider Business Practice Location Address
First Line : 8610 GEORGIA AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-3404
Country : US
Telephone Number : 301-589-2714
Fax Number : 301-589-3828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 05/28/2014

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