Provider Demographics
NPI:1255149019
Name:BERGEN GENTLE DENTAL LLC
Entity type:Organization
Organization Name:BERGEN GENTLE DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:551-587-3685
Mailing Address - Street 1:12 HODSKIN PL
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2604
Mailing Address - Country:US
Mailing Address - Phone:551-587-3685
Mailing Address - Fax:
Practice Address - Street 1:1033 RIVER RD STE 1
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-3100
Practice Address - Country:US
Practice Address - Phone:201-836-7166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty