Healthcare Provider Details

I. General information

NPI: 1407872492
Provider Name (Legal Business Name): STEVEN J BECKER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1-B RIVERDALE DRIVE 1-B
HAMPTON VI
23666-3597
US

IV. Provider business mailing address

1-B RIVERDALE DRIVE 1-B
HAMPTON VI
23666-3597
US

V. Phone/Fax

Practice location:
  • Phone: 757-838-7879
  • Fax: 757-838-7879
Mailing address:
  • Phone: 757-838-7879
  • Fax: 757-838-7879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401004597
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: