Provider Demographics
NPI:1386514941
Name:GUBERMAN, JAIME (DMD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:GUBERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 PARK AVE APT 1G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8058
Mailing Address - Country:US
Mailing Address - Phone:973-647-9006
Mailing Address - Fax:
Practice Address - Street 1:530 PARK AVE APT 1G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8058
Practice Address - Country:US
Practice Address - Phone:973-647-9006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065152-011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics