Provider Demographics
NPI:1346971058
Name:BERMUDEZ, JULIO ABRAHAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:ABRAHAN
Last Name:BERMUDEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S CONKLING ST APT 513
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5349
Mailing Address - Country:US
Mailing Address - Phone:954-483-6999
Mailing Address - Fax:
Practice Address - Street 1:8055 RITCHIE HWY STE 102
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1074
Practice Address - Country:US
Practice Address - Phone:954-483-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17474122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist