MEDICARE: DR. JOHN PAUL BELBAS D.D.S.

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	1223G0001X	General Practice Dentistry	040286	NY
2	1223G0001X	General Practice Dentistry	6381	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053487934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PAUL BELBAS D.D.S.

Provider Business Mailing Address
First Line	:	5995 BIG TREE RD
Second Line	:	SUITE B
City	:	LAKEVILLE
State	:	NY
Zip	:	14480-9735
Country	:	US
Telephone Number	:	585-346-5220
Fax Number	:	585-346-5889

Provider Business Practice Location Address
First Line	:	5995 BIG TREE RD
Second Line	:	SUITE B
City	:	LAKEVILLE
State	:	NY
Zip	:	14480-9735
Country	:	US
Telephone Number	:	585-346-5220
Fax Number	:	585-346-5889

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	07/09/2007

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