Provider Demographics
NPI:1083707673
Name:BERGER & JEN KIN DDS INC
Entity Type:Organization
Organization Name:BERGER & JEN KIN DDS INC
Other - Org Name:DENTAL GROUP OF SIMI VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HERSCHEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-522-6020
Mailing Address - Street 1:1720 E LOS ANGELES AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-522-6020
Mailing Address - Fax:805-522-6432
Practice Address - Street 1:1720 E LOS ANGELES AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065
Practice Address - Country:US
Practice Address - Phone:805-522-6020
Practice Address - Fax:805-522-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty