Provider Demographics
NPI:1205972650
Name:MICHAEL BERNFELD DDS MICHAEL KORNGOLD DDS
Entity type:Organization
Organization Name:MICHAEL BERNFELD DDS MICHAEL KORNGOLD DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KORNGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-252-8989
Mailing Address - Street 1:1801 AVENUE M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5348
Mailing Address - Country:US
Mailing Address - Phone:718-252-8989
Mailing Address - Fax:718-377-3062
Practice Address - Street 1:1801 AVENUE M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5348
Practice Address - Country:US
Practice Address - Phone:718-252-8989
Practice Address - Fax:718-377-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35130122300000X
NY323641223E0200X
NY425091223P0300X
NY301181223P0700X
NY433801223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty