Provider Demographics
NPI:1376727685
Name:BERKINSHAW, EDWIN ROBERT (DDS)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:ROBERT
Last Name:BERKINSHAW
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 1:129 OLD SOLOMONS ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3825
Mailing Address - Country:US
Mailing Address - Phone:410-266-8880
Mailing Address - Fax:410-224-3297
Practice Address - Street 1:129 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3825
Practice Address - Country:US
Practice Address - Phone:410-266-8880
Practice Address - Fax:410-224-3297
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD76581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics