Provider Demographics
NPI:1780878710
Name:BIERMAN, JEFFREY ALLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:BIERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 E ANDREW RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:IL
Mailing Address - Zip Code:62684-9642
Mailing Address - Country:US
Mailing Address - Phone:217-496-2301
Mailing Address - Fax:217-496-2298
Practice Address - Street 1:2515 E ANDREW RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:IL
Practice Address - Zip Code:62684-9642
Practice Address - Country:US
Practice Address - Phone:217-496-2301
Practice Address - Fax:217-496-2298
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019017404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL37-1089779OtherEIN