Provider Demographics
NPI:1750367181
Name:BERENSHTEYN, FLORA (DDS)
Entity type:Individual
Prefix:DR
First Name:FLORA
Middle Name:
Last Name:BERENSHTEYN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1907
Mailing Address - Country:US
Mailing Address - Phone:718-934-0405
Mailing Address - Fax:718-934-6944
Practice Address - Street 1:3705 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1907
Practice Address - Country:US
Practice Address - Phone:718-934-0405
Practice Address - Fax:718-934-6944
Is Sole Proprietor?:No
Enumeration Date:2005-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0477601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02190816Medicaid