MEDICARE: ARTURO J BEJARANO JR DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	012791	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750522413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTURO J BEJARANO JR DDS PC

Provider Business Mailing Address
First Line	:	5630 GATEWAY BLVD E STE 4
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79905-1748
Country	:	US
Telephone Number	:	915-772-5200
Fax Number	:	915-772-8907

Provider Business Practice Location Address
First Line	:	5630 GATEWAY BLVD E STE 4
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79905-1748
Country	:	US
Telephone Number	:	915-772-5200
Fax Number	:	915-772-8907

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ARTURO J BEJARANO
Credential	:	D.D.S.
Telephone Number	:	915-772-5200

Provider Enumeration Date	:	03/10/2009
Last Update Date	:	10/18/2013

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