Provider Demographics
NPI:1932965308
Name:BERINATO, JODY (RDH, BS)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:BERINATO
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7831 SHEPHERD AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5415
Mailing Address - Country:US
Mailing Address - Phone:410-303-6507
Mailing Address - Fax:
Practice Address - Street 1:20 E TIMONIUM RD STE 300
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3458
Practice Address - Country:US
Practice Address - Phone:410-252-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6592124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist