Healthcare Provider Details

I. General information

NPI: 1629427547
Provider Name (Legal Business Name): BRITTANY BEJEL D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N SUMNEYTOWN PIKE STE 2B
NORTH WALES PA
19454-2530
US

IV. Provider business mailing address

311 N SUMNEYTOWN PIKE STE 2B
NORTH WALES PA
19454-2530
US

V. Phone/Fax

Practice location:
  • Phone: 305-338-4463
  • Fax:
Mailing address:
  • Phone: 215-699-4477
  • Fax: 215-699-5570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI02641600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS040783
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: