MEDICARE: DR. JOSEPH G. VAN CLEVE 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	7051	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	:	1134288285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH G. VAN CLEVE D.D.S.

Provider Business Mailing Address
First Line	:	2252 W MAGEE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-4329
Country	:	US
Telephone Number	:	520-447-5348
Fax Number	:

Provider Business Practice Location Address
First Line	:	2252 W MAGEE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-4329
Country	:	US
Telephone Number	:	520-447-5348
Fax Number	:

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	05/17/2019

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