Healthcare Provider Details

I. General information

NPI: 1720547227
Provider Name (Legal Business Name): GABRIELLE BEKOV DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E ATLANTIC BLVD FL 2
POMPANO BEACH FL
33060-6768
US

IV. Provider business mailing address

211 189TH TER
SUNNY ISLES BEACH FL
33160-2311
US

V. Phone/Fax

Practice location:
  • Phone: 914-310-5014
  • Fax: 954-666-0493
Mailing address:
  • Phone: 914-310-5014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN26277
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: