Provider Demographics
NPI:1306159165
Name:BERMUDEZ, JULIANA P (DDS)
Entity type:Individual
Prefix:MS
First Name:JULIANA
Middle Name:P
Last Name:BERMUDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11332 HEADLANDS CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3636
Mailing Address - Country:US
Mailing Address - Phone:909-533-1976
Mailing Address - Fax:
Practice Address - Street 1:851 W STATE ROAD 436
Practice Address - Street 2:SUITE 1021
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3000
Practice Address - Country:US
Practice Address - Phone:407-786-5559
Practice Address - Fax:407-786-5554
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014181341223G0001X
FLDN188621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice