Healthcare Provider Details

I. General information

NPI: 1669656138
Provider Name (Legal Business Name): DAVID ISRAEL BELLER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 N BETHLEHEM PIKE
SPRINGHOUSE PA
19477
US

IV. Provider business mailing address

PO BOX 29
SPRING HOUSE PA
19477-0029
US

V. Phone/Fax

Practice location:
  • Phone: 215-641-9020
  • Fax: 215-540-9021
Mailing address:
  • Phone: 215-641-9020
  • Fax: 215-540-9021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS026288L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierDS026288L
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerDENTAL LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: