Provider Demographics
NPI:1346239688
Name:BERKOWITZ, LEONARD IRWIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:IRWIN
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CHABLIS DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5834
Mailing Address - Country:US
Mailing Address - Phone:631-673-6096
Mailing Address - Fax:631-549-1026
Practice Address - Street 1:3 CHABLIS DR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5834
Practice Address - Country:US
Practice Address - Phone:631-673-6096
Practice Address - Fax:631-549-1026
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0306561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice