Healthcare Provider Details

I. General information

NPI: 1083142301
Provider Name (Legal Business Name): ROBERT A. BEECH, DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 HOLLENBECK AVE STE 104
SUNNYVALE CA
94087-4300
US

IV. Provider business mailing address

1565 HOLLENBECK AVE STE 104
SUNNYVALE CA
94087-4300
US

V. Phone/Fax

Practice location:
  • Phone: 408-245-6010
  • Fax: 408-245-6018
Mailing address:
  • Phone: 408-245-6010
  • Fax: 408-245-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number61304
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT A BEECH
Title or Position: OWNER/ SURGEON
Credential: DDS
Phone: 408-245-6010