Provider Demographics
NPI:1831210319
Name:KIM-BERMAN, HERA (DDS)
Entity type:Individual
Prefix:DR
First Name:HERA
Middle Name:
Last Name:KIM-BERMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HERA
Other - Middle Name:
Other - Last Name:BERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1078
Mailing Address - Country:US
Mailing Address - Phone:734-764-1520
Mailing Address - Fax:734-763-8100
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1078
Practice Address - Country:US
Practice Address - Phone:734-764-1520
Practice Address - Fax:734-763-8100
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010211541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics