Healthcare Provider Details

I. General information

NPI: 1518055359
Provider Name (Legal Business Name): LUKMAN BILAL BECKLES D.D.S.,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8730 GEORGIA AVE #308
SILVER SPRING MD
20910-3604
US

IV. Provider business mailing address

8730 GEORGIA AVE #308
SILVER SPRING MD
20910-3604
US

V. Phone/Fax

Practice location:
  • Phone: 301-565-3333
  • Fax: 301-565-3336
Mailing address:
  • Phone: 301-565-3333
  • Fax: 301-565-3336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number13799
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: