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General NPI Number Information
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NPI Number | 1023413424
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Entity Type | Individual
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Provider Name | ELENA BEDILO DMD
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Gender | Female
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 09/07/2020
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Provider Practice Location Address
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Address Line | 3500 LITTLE YORK RD STE A1
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City | HOUSTON
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State | TX
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Zip | 77093-3600
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Country | US
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Telephone | 713-766-3352
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Fax |
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Provider Business Mailing Address
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Address Line | 30 EGRET LN
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City | ALISO VIEJO
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State | CA
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Zip | 92656-1759
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30190
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License Number State | TX
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