Provider Demographics
NPI:1003019175
Name:BERNARDI, ALENUSH D (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALENUSH
Middle Name:D
Last Name:BERNARDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5305 HARTER LN
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1840
Mailing Address - Country:US
Mailing Address - Phone:818-384-1590
Mailing Address - Fax:
Practice Address - Street 1:1110 N BRAND BLVD STE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2567
Practice Address - Country:US
Practice Address - Phone:818-244-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46559122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist