Provider Demographics
NPI:1518199934
Name:DEBERADINIS, DEBORAH A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:DEBERADINIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:A
Other - Last Name:REICHHELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 OVERLOOK DR
Mailing Address - Street 2:SUITE #6
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2831
Mailing Address - Country:US
Mailing Address - Phone:603-672-0844
Mailing Address - Fax:603-672-5972
Practice Address - Street 1:5 OVERLOOK DR
Practice Address - Street 2:SUITE #6
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2831
Practice Address - Country:US
Practice Address - Phone:603-672-0844
Practice Address - Fax:603-672-5972
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH21771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics