Provider Demographics
NPI:1699853978
Name:SHELDON S. BERKMAN, D.M.D., P.A.
Entity Type:Organization
Organization Name:SHELDON S. BERKMAN, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:S
Authorized Official - Last Name:BERKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-771-1200
Mailing Address - Street 1:2999 PRINCETON PIKE
Mailing Address - Street 2:4
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-3291
Mailing Address - Country:US
Mailing Address - Phone:609-771-1200
Mailing Address - Fax:609-771-0707
Practice Address - Street 1:2999 PRINCETON PIKE
Practice Address - Street 2:SUITE 4
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3261
Practice Address - Country:US
Practice Address - Phone:609-771-1200
Practice Address - Fax:609-771-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ94331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid