Individual provider · Type 1 NPI

Michele Shoshana Bergen, DMD, MD

Oral and Maxillofacial Surgery (Dentist) · Greenwich, CT

NPI number 1215929286 Active

Practice location

49 Lake Ave
Greenwich, CT 06830-4501

Call (203) 661-4231 Map

Fax (203) 661-0155

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X009275 (CT)
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X042206 (CT)
Oral and Maxillofacial Surgery (Dentist) 1223S0112X050181 (NY)
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X231685 (NY)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1215929286

Michele Shoshana Bergen, DMD, MD's National Provider Identifier is 1215929286, issued on Aug 16, 2005. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Greenwich, CT. The record was last updated on Aug 8, 2012.