Provider Demographics
NPI:1871343665
Name:BERKENPAS, SOPHIA LYNN (DDS)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:LYNN
Last Name:BERKENPAS
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 1:2743 DUPONT AVE S APT 3
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-1277
Mailing Address - Country:US
Mailing Address - Phone:763-516-4718
Mailing Address - Fax:
Practice Address - Street 1:74-5214 KEANALEHU DR
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-355-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program