Provider Demographics
NPI:1336354257
Name:BERLIN, JOEL WARNER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:WARNER
Last Name:BERLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 BONNY OAKS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-6003
Mailing Address - Country:US
Mailing Address - Phone:423-894-5764
Mailing Address - Fax:423-899-3044
Practice Address - Street 1:6425 BONNY OAKS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-6003
Practice Address - Country:US
Practice Address - Phone:423-894-5764
Practice Address - Fax:423-899-3044
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13651223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics