Provider Demographics
NPI:1821437666
Name:BERNING, JEREMY L (DMD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:L
Last Name:BERNING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2783 GLENHAVEN AVE
Mailing Address - Street 2:APT C
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44321
Mailing Address - Country:US
Mailing Address - Phone:419-297-3333
Mailing Address - Fax:
Practice Address - Street 1:2783 GLENHAVEN AVE
Practice Address - Street 2:APT C
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-2179
Practice Address - Country:US
Practice Address - Phone:419-297-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0239851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice