MEDICARE: VICTORIA BEJARANO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN28149	FL

General Provider Information

NPI Number	:	1013697069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA BEJARANO DMD

Provider Business Mailing Address
First Line	:	1913 N CLYDE MORRIS BLVD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5519
Country	:	US
Telephone Number	:	386-274-2021
Fax Number	:

Provider Business Practice Location Address
First Line	:	1913 N CLYDE MORRIS BLVD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32117-5519
Country	:	US
Telephone Number	:	386-274-2021
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	04/22/2026

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