Provider Demographics
NPI:1841963931
Name:SUER, BERKAY T (DDS)
Entity type:Individual
Prefix:DR
First Name:BERKAY
Middle Name:T
Last Name:SUER
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 1:483 MIDDLE TPKE W
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-3863
Mailing Address - Country:US
Mailing Address - Phone:860-645-0111
Mailing Address - Fax:
Practice Address - Street 1:483 MIDDLE TPKE W
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3863
Practice Address - Country:US
Practice Address - Phone:860-645-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115078-01122300000X
FLDN25993122300000X
NJ22DI02870600122300000X
CT13179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY115078-01OtherDENTAL BOARD OF NEW YORK STATE