Provider Demographics
NPI:1538232590
Name:BERMAN, ROBERT G (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:BERMAN
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 1:225 TERRY AVE N
Mailing Address - Street 2:#100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5206
Mailing Address - Country:US
Mailing Address - Phone:206-622-2999
Mailing Address - Fax:
Practice Address - Street 1:1229 MADISON ST STE 870
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1357
Practice Address - Country:US
Practice Address - Phone:206-622-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000053871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice