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General NPI Number Information
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NPI Number | 1629352661
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Entity Type | Individual
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Provider Name | SIMON BEYLIN DDS, MDT
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Gender | Male
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 33 BARTLETT ST SUITE 501
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City | LOWELL
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State | MA
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Zip | 01852-1334
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Country | US
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Telephone | 978-425-1496
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Fax |
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Provider Business Mailing Address
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Address Line | 33 BARTLETT ST SUITE 501
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City | LOWELL
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State | MA
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Zip | 01852-1334
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Country | US
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Telephone | 978-425-1496
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 055915
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10783
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 60820
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN1856357
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License Number State | MA
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