Provider Demographics
NPI:1659613115
Name:BRANDI BERLAND R.D.H., LTD
Entity Type:Organization
Organization Name:BRANDI BERLAND R.D.H., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DENTAL HYGIENIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:414-403-7181
Mailing Address - Street 1:11216 61ST ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7261
Mailing Address - Country:US
Mailing Address - Phone:262-764-5237
Mailing Address - Fax:
Practice Address - Street 1:11216 61ST ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7261
Practice Address - Country:US
Practice Address - Phone:262-764-5237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9824-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty