Provider Demographics
NPI:1730849282
Name:BERKSHIRE DENTAL HEALTH PC
Entity type:Organization
Organization Name:BERKSHIRE DENTAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DERMODY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-358-3923
Mailing Address - Street 1:553 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4378
Mailing Address - Country:US
Mailing Address - Phone:413-448-8909
Mailing Address - Fax:
Practice Address - Street 1:553 TYLER ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4378
Practice Address - Country:US
Practice Address - Phone:413-448-8909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-26
Last Update Date:2021-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADN1858785OtherMA DENTAL LICENSE