Provider Demographics
NPI:1942883590
Name:GENTLE ENDODONTIC SPECIALISTS
Entity Type:Organization
Organization Name:GENTLE ENDODONTIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMAYON
Authorized Official - Middle Name:
Authorized Official - Last Name:BERENJI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS DMD
Authorized Official - Phone:949-923-8909
Mailing Address - Street 1:600 LOUIS DR STE 105
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2844
Mailing Address - Country:US
Mailing Address - Phone:267-991-9696
Mailing Address - Fax:
Practice Address - Street 1:600 LOUIS DR STE 105
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2844
Practice Address - Country:US
Practice Address - Phone:267-991-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty