Provider Demographics
NPI:1568774719
Name:BERLIN, JULIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:
Last Name:BERLIN
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 1:200 LESLIE DR APT 812
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7317
Mailing Address - Country:US
Mailing Address - Phone:646-409-6540
Mailing Address - Fax:
Practice Address - Street 1:3027 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-246-4777
Practice Address - Fax:954-246-4577
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-03
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05559611223P0221X
FLDN223331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry