Healthcare Provider Details

I. General information

NPI: 1881069680
Provider Name (Legal Business Name): BEACON DENTAL HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 TREMONT ST SUITE 436
BOSTON MA
02116-4705
US

IV. Provider business mailing address

198 TREMONT ST SUITE 436
BOSTON MA
02116-4705
US

V. Phone/Fax

Practice location:
  • Phone: 617-418-6940
  • Fax: 617-418-6940
Mailing address:
  • Phone: 617-418-6940
  • Fax: 617-418-6940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANK E SCHIANO
Title or Position: PRESIDENT
Credential: DMD
Phone: 617-418-6940