Active NPI
Regina Gelman-Bercovich, DMD
- Pediatric Dentistry
- Doral, FL
National Provider Identifier
1063994333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN19630
- Practice address
- 7520 NW 104TH Ave Unit A105
Doral, FL 33178-3375 - Phone
- (786) 408-0177
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN19630 | FL | Primary |
Addresses
Primary practice location
7520 NW 104TH Ave Unit A105
Doral, FL 33178-3375
Mailing address
1546 Breakwater Ter
Hollywood, FL 33019-5023
Phone (617) 817-0709
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN19630 | FL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1063994333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1546 BREAKWATER TER",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330195023",
"telephone_number": "617-817-0709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7520 NW 104TH AVE UNIT A105",
"city": "DORAL",
"state": "FL",
"postal_code": "331783375",
"telephone_number": "786-408-0177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELMAN-BERCOVICH",
"first_name": "REGINA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN19630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Doral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.