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General NPI Number Information
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NPI Number | 1528215431
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Entity Type | Individual
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Provider Name | SAMUEL BECK DMD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | NAVAL HEALTH CLINIC HAWAII 480 CENTRAL AVENUE
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City | PEARL HARBOR
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State | HI
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Zip | 96860
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Country | US
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Telephone | 808-474-4242
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Fax |
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Provider Business Mailing Address
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Address Line | NAVAL HEALTH CLINIC HAWAII 480 CENTRAL AVENUE
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City | PEARL HARBOR
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State | HI
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Zip | 96860-4908
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Country | US
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Telephone | 808-474-4242
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Fax | 808-471-0918
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | D4377-OS
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D4377-OS
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0401417924
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License Number State | VA
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