Provider Demographics
NPI:1962414276
Name:BERKEY, MARGARET M (DDS)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:M
Last Name:BERKEY
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 1:435 ARDEN AVE STE 445
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4050
Mailing Address - Country:US
Mailing Address - Phone:818-242-3731
Mailing Address - Fax:818-242-3731
Practice Address - Street 1:435 ARDEN AVE STE 445
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4050
Practice Address - Country:US
Practice Address - Phone:818-242-3731
Practice Address - Fax:818-242-3731
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA277301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
95-4102592OtherTAX IDENTIFICATION NUMBER
CAGG93907-01OtherDENTI-CAL PROVIDER ID #