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General NPI Number Information
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NPI Number | 1861143497
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Entity Type | Organization
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Legal Business Name | BEDDAWI, DDS
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 2204 GRANT RD STE 202
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-3877
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Country | US
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Telephone | 650-800-9414
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Fax | 650-800-9460
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Provider Business Mailing Address
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Address Line | 2204 GRANT RD STE 202
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-3877
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Country | US
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Telephone | 650-800-9414
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Fax | 650-800-9460
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Authorized Official
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Title or Position | PRESIDENT
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Name | YARAH BEDDAWI
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Credential | DDS
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Telephone | 650-800-9414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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