Healthcare Provider Details

I. General information

NPI: 1164326138
Provider Name (Legal Business Name): BESTIE LIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 GENERALS HWY
CROWNSVILLE MD
21032-1421
US

IV. Provider business mailing address

737 E COLLEGE PKWY
ANNAPOLIS MD
21409-5689
US

V. Phone/Fax

Practice location:
  • Phone: 410-923-2586
  • Fax:
Mailing address:
  • Phone: 410-224-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: GENA SCHULTHEIS
Title or Position: OWNER
Credential: DDS
Phone: 410-905-8738