Provider Demographics
NPI:1568212918
Name:ANDREA P BERNHARDT DDS INC
Entity Type:Organization
Organization Name:ANDREA P BERNHARDT DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BERNHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:657-223-0012
Mailing Address - Street 1:7530 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4524
Mailing Address - Country:US
Mailing Address - Phone:657-223-0012
Mailing Address - Fax:657-223-0014
Practice Address - Street 1:7530 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-4524
Practice Address - Country:US
Practice Address - Phone:657-223-0012
Practice Address - Fax:657-223-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA103226OtherDENTAL LICENSE