Provider Demographics
NPI:1740382761
Name:BERMAN, JOSEPHINE CHIANELLO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:CHIANELLO
Last Name:BERMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 80TH ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142
Mailing Address - Country:US
Mailing Address - Phone:262-697-5444
Mailing Address - Fax:262-694-1650
Practice Address - Street 1:3600 80TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142
Practice Address - Country:US
Practice Address - Phone:262-697-5444
Practice Address - Fax:262-694-1650
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI 44571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice