Elizabeth Ann Bernhard, DMD

Individual provider Active NPI Public Health Dentistry · Smithfield, VA

NPI 1073604765 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1073604765
Entity type
Individual (NPI type 1)
Primary specialty
Public Health Dentistry 1223D0001X
License
0401004974 (VA)
Practice address
402 Grace St
Smithfield, VA 23430-1134
Phone
(757) 357-4177
Fax
(757) 357-2838
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0401004974VAMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth of Virginia State Board of Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 0401004974 VA Yes

Addresses

Primary practice location

402 Grace St
Smithfield, VA 23430-1134

Mailing address

402 Grace St
Smithfield, VA 23430-1134
Phone (757) 357-4177

Other providers in Smithfield, VA

All providers in Smithfield, VA · Public Health Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.