Provider Demographics
NPI:1710010376
Name:SPERBER, HOWARD E (DDS)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:E
Last Name:SPERBER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28001 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4559
Mailing Address - Country:US
Mailing Address - Phone:216-831-6822
Mailing Address - Fax:216-831-0910
Practice Address - Street 1:28001 CHAGRIN BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44122-4559
Practice Address - Country:US
Practice Address - Phone:216-831-6822
Practice Address - Fax:216-831-0910
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH129791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0086731Medicaid